NICOLE FALLS DPT
NPI 1568007029
Physical Therapist in Brewer, ME
NPI Status: Active since November 08, 2019
Contact Information
248 STATE ST
BREWER, ME
ZIP 04412
Phone: (207) 989-2034
- Individual
- Female
- Years of Experience 7
- Physical Therapist
- Accepts Insurance
- Accepts Medicare Approved Payment
About NICOLE FALLS
This page provides the complete NPI Profile along with additional information for Nicole Falls, a provider established in Brewer, Maine with a medical specialization in Physical Therapist and more than 7 years of experience. The healthcare provider is registered in the NPI registry with number 1568007029 assigned on November 2019. The practitioner's primary taxonomy code is 225100000X. The provider is registered as an individual and her NPI record was last updated 2 years ago.
- NPI
- 1568007029
- Provider Name
- NICOLE FALLS DPT
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 248 STATE ST BREWER, ME 04412
- Location Phone
- (207) 989-2034
- Mailing Address
- 248 STATE ST BREWER, ME 04412
- Medical School Name
- OTHER
- Graduation Year
- 2019
- Is Sole Proprietor?
- No
- Enumeration Date
- 11-08-2019
- Last Update Date
- 10-03-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physical Therapist
- Taxonomy Code
- 225100000X
- Type
- Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Taxonomy Description
- Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
- Medica Individual Choice Bronze HSA - EPO
- Medica Individual Choice Bronze Share - EPO
- Medica Individual Choice Bronze Share - HMO
- Medica Individual Choice Expanded Bronze Standard - EPO
- Medica Individual Choice Expanded Bronze Standard - HMO
- Medica Individual Choice Gold $0 Copay PCP Visits - EPO
- Medica Individual Choice Gold $0 Copay PCP Visits - HMO
- Medica Individual Choice Gold Share - EPO
- Medica Individual Choice Gold Share - HMO
- Medica Individual Choice Gold Standard - EPO
- Medica Individual Choice Gold Standard - HMO
- Medica Individual Choice Silver $0 Copay PCP Visits - EPO
- Medica Individual Choice Silver $0 Copay PCP Visits - HMO
- Medica Individual Choice Silver Share - EPO
- Medica Individual Choice Silver Share - HMO
- Medica Individual Choice Silver Standard - EPO
- Medica Individual Choice Silver Standard - HMO
- Premier $1,500 - 25% - HMO
- Premier $3,500 - 30% - HMO
- Premier $4,100 HDHP - HMO
- Premier $5,000 - 40% - HMO
- Premier $6,200 HDHP - HMO
- Premier $7,500 - HMO
- Premier $9,200 - HMO
- Premier Protection - HMO
- Premier HMO $1,500 - 30% - HMO
- Premier HMO $2,500 - 20% Copay - HMO
- Premier HMO $3,300 - 30% HDHP - HMO
- Premier HMO $3,500 - 30% - HMO
- Premier HMO $3,500 HDHP - HMO
- Premier HMO $4,000 - 20% HDHP - HMO
- Premier HMO $5,000 - 20% HDHP - HMO
- Premier HMO $5,500 - 30% Copay - HMO
- Premier HMO $7,050 HDHP - HMO
- Premier HMO $750 - 10% - HMO
- Premier HMO $9,100 - HMO
- Premier POS $1,500 - 30% - POS
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Nicole Falls is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
PECOS PAC ID: 6204281801
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20231018000074
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.64 for a new patient copayment and $16.68 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 04412 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.58
- Minimum New Patient Price $53.26
- Maximum New Patient Price $162.77
- Average New Patient Copayment $20.64
- Minimum New Patient Copayment $13.31
- Maximum New Patient Copayment $40.69
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $66.74
- Minimum Established Patient Price $16.9
- Maximum Established Patient Price $132.79
- Average Established Patient Copayment $16.68
- Minimum Established Patient Copayment $4.22
- Maximum Established Patient Copayment $33.19
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Reviews for NICOLE FALLS DPT
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 5 | 6 | 8 | 0 | 0 | 7 | 0 | 2 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 5 | 12 | 8 | 0 | 0 | 14 | 0 | 4 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 5 + 1 + 2 + 8 + 0 + 0 + 1 + 4 + 0 + 4 + 24 = 51 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 51 = 9 | 9 | ||||||||
The NPI number 1568007029 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 17 providers are registered at the same or nearby location.
JODY MCCANNELL SLP
Speech-Language Pathologist
248 STATE ST
BREWER, ME
ZIP 04412
JENNIFER MORGAN SLP
Speech-Language Pathologist
248 STATE ST
BREWER, ME
ZIP 04412
AMY MORRISON OT
Occupational Therapist
248 STATE ST
BREWER, ME
ZIP 04412
MEREDITH ALLBRIGHT P.T.
Physical Therapist
248 STATE ST
BREWER, ME
ZIP 04412
REGAN CARD P.T.
Physical Therapist
248 STATE ST
BREWER, ME
ZIP 04412
CORINNE JOHNSTON LSW
Social Worker
248 STATE ST
BREWER, ME
ZIP 04412
LAURA SMITH CTRS
Recreation Therapist
248 STATE ST
BREWER, ME
ZIP 04412
CHRISTOPHER JORDAN CTRS
Recreation Therapist
248 STATE ST
BREWER, ME
ZIP 04412
ANNE PORTER CTRS
Recreation Therapist
248 STATE ST
BREWER, ME
ZIP 04412
TIFFANY PELLERIN COTA
Occupational Therapy Assistant
248 STATE ST
BREWER, ME
ZIP 04412
DEEANNE FOWLIE RN
Registered Nurse
(Rehabilitation)
248 STATE ST
BREWER, ME
ZIP 04412
KAREN BEALE P.T
Physical Therapist
248 STATE ST
BREWER, ME
ZIP 04412
ELLEN CIHIWSKY LCPC
Rehabilitation Counselor
248 STATE ST
BREWER, ME
ZIP 04412
MR. RONALD FALCO PTA
Physical Therapy Assistant
248 STATE ST
BREWER, ME
ZIP 04412
REHAB WITHOUT WALLS, INC.
In Home Supportive Care
248 STATE ST
BREWER, ME
ZIP 04412
KRISTI MCGOWN PT
Physical Therapist
248 STATE ST
BREWER, ME
ZIP 04412
RWW OUTPATIENT REHAB SERVICES, INC.
In Home Supportive Care
248 STATE ST
BREWER, ME
ZIP 04412
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568007029, enumerated as an "individual" on November 08, 2019.
The provider is located at 248 STATE ST BREWER, ME 04412 and the phone number is (207) 989-2034.
Physical Therapist with taxonomy code 225100000X.
The provider might be accepting Accepts: Medica and Security Health Plan. Please consult your insurance carrier or call the provider to verify.
