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NICOLE GRACE FERNANDEZ DO
NPI 1477119774
Psychiatry & Neurology - Psychiatry in Winston Salem, NC

Active since May 13, 2019PECOS EnrolledAccepts Medicare Assignment
175 KIMEL PARK DR STE 100, WINSTON SALEM, NC 27103(336) 718-3550 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 15, 2026, Apr 18, 2024, May 13, 2019 (3 updates tracked since 2019).

About Nicole Grace Fernandez Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE GRACE FERNANDEZ DO (NPI 1477119774) is an individual psychiatry provider in Winston Salem, North Carolina, licensed in North Carolina (2025-03539) and active in the NPI registry since May 2019. She is enrolled in Medicare PECOS, is affiliated with St John's Episcopal Hospital At South Shore, and maintains a secondary practice location in Far Rockaway.

NPPES Registry Identity

NPI1477119774
Entity TypeIndividualFemale
Primary Taxonomy2084P0800X
Provider Legal NameNICOLE GRACE FERNANDEZCredential: DO
Location Address175 KIMEL PARK DR STE 100Winston Salem, NC 27103-6951
Mailing AddressPo Box 751803Charlotte, NC 28275-1803
Phone(336) 718-3550
Sole ProprietorNo
Medical School CMSOtherGraduated 2019
Enumeration DateMay 13, 2019
Last NPPES UpdateJanuary 15, 20263 updates tracked since enumeration
NPPES CertifiedJanuary 15, 2026
✔ NPI 1477119774 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians
Taxonomy Code2084P0800X
License✔ Licensed in NC · 2025-03539
Definition
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Also ListedPsychiatry & Neurology · Psychosomatic MedicineTaxonomy 2084P0015X · License 330439 (NY)
175 KIMEL PARK DR STE 100, Winston Salem, NC 27103
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Secondary Practice Location 1

Location 1327 Beach 19th StFar Rockaway, NY 11691-4423 · Phone (718) 869-7000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Grace Fernandez Do is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961999271
PECOS Enrollment IDI20260113001386
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Nicole Fernandez reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Forsyth Memorial Hospital, Inc.
Same address
Dermatology
175 KIMEL PARK DR
Winston Salem, NC 27103
  • Reassigned Medicare billing, North Carolina enrollment
  • 1,202 clinicians in this Medicare group
NPI 1114649894 (704) 384-4000
Novant Medical Group, Inc
Same address
Neurology
175 KIMEL PARK DR, SUITE 100
Winston Salem, NC 27103
  • Reassigned Medicare billing, North Carolina enrollment
  • Medicare enrollment name: Novant Health Medical Group, LLC
  • 2,998 clinicians in this Medicare group
NPI 1043503287 (336) 277-1800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St John's Episcopal Hospital At South Shore

Acute Care Hospitals · Far Rockaway, NY
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330395
Location327 Beach 19th StreetFar Rockaway, NY 11691 · Queens County
Emergency services Birthing friendly

Novant Health Forsyth Medical Center

Acute Care Hospitals · Winston-Salem, NC
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number340014
Location3333 Silas Creek ParkwayWinston-Salem, NC 27103 · Forsyth County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27103 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$165.09 typical visit price
range $54.12 – $165.09
Typical copayment $41.27 (range $13.53 – $41.27)
Most-billed visit code 99205
Established Patient
$67.72 typical visit price
range $17.21 – $134.61
Typical copayment $16.93 (range $4.30 – $33.65)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. MINDY PARIS FRANCE NCC, LPC
Counselor (Professional)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 277-1800
ERIN TAGGE
Counselor (Mental Health)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
TRESSA ANITA CORBETT LCSW, LCAS
Social Worker (Clinical)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
MRS. MIKALA JONES DILLARD PMHNP-BC
Nurse Practitioner
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
KATHRYN MICHELLE MURRAY LCSW
Social Worker (Clinical)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
ALISON BRIDGES RUSSO LCSW
Social Worker (Clinical)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
COREY LANE GOSNELL PA-C
Physician Assistant
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550
BRIAN ANDREW FARAH M.D.
Psychiatry & Neurology (Psychiatry)
175 KIMEL PARK DR STE 100
WINSTON SALEM, NC 27103
Forsyth County (336) 718-3550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Fernandez's NPI number?

The NPI number for Nicole Fernandez is 1477119774. It was assigned to this individual provider in the NPPES registry on May 13, 2019.

Where is Nicole Fernandez located?

Nicole Fernandez practices at 175 Kimel Park Dr Ste 100, Winston Salem, NC 27103. The listed phone number is (336) 718-3550.

What is Nicole Fernandez's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Is Nicole Fernandez enrolled in Medicare?

Yes. Nicole Fernandez is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Nicole Fernandez's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Fernandez reassigns Medicare benefits to 2 organizations: Forsyth Memorial Hospital, Inc. (Winston Salem, NC) and Novant Medical Group, Inc (Winston Salem, NC). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Fernandez's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Fernandez accept?

Health plans from Blue Cross and Blue Shield of NC list Nicole Fernandez as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nicole Fernandez affiliated with any hospitals?

According to CMS data, Nicole Fernandez is affiliated with St John's Episcopal Hospital At South Shore and Novant Health Forsyth Medical Center.

When was this NPI record last updated?

The NPPES record for Nicole Fernandez was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.