DR. JOHN THOMAS NELSON M.D.
NPI 1578857652
Orthopaedic Surgery in Raleigh, NC

Q: What is John Nelson's NPI number?

The NPI number for John Nelson is 1578857652. It was assigned to this individual provider in the NPPES registry on June 6, 2011.

Q: What is John Nelson's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for John Nelson was last updated on January 8, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.

Active since June 06, 2011PECOS EnrolledAccepts Medicare Assignment

98.33/100

CMS Quality Rating

3801 WAKE FOREST RD STE 220, RALEIGH, NC 27609(919) 872-5296 Get Directions Write a Review

NPPES record last updated: January 8, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jan 8, 2020, Aug 16, 2019, Aug 1, 2018 (3 updates tracked since 2018).

On this page

About Dr. John Thomas Nelson M.d. NPPES

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

DR. JOHN THOMAS NELSON M.D. (NPI 1578857652) is an individual orthopaedic surgery provider in Raleigh, North Carolina, licensed in North Carolina (2019-02129) and active in the NPI registry since June 2011. He is enrolled in Medicare PECOS, is affiliated with Duke University Hospital, and maintains a secondary practice location in Pittsburgh.

NPPES Registry Identity

NPI1578857652

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. JOHN THOMAS NELSONCredential: M.D.

Location Address3801 WAKE FOREST RD STE 220Raleigh, NC 27609

Mailing Address3801 Wake Forest Rd Ste 220Raleigh, NC 27609-6864 · (919) 872-5296

Phone(919) 872-5296

Sole ProprietorNo

Medical School CMSUniversity Of Texas Medical School At San AntonioGraduated 2011

Enumeration DateJune 6, 2011

Last NPPES UpdateJanuary 8, 20203 updates tracked since enumeration

✔ NPI 1578857652 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in NC · 2019-02129

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

3801 WAKE FOREST RD STE 220, Raleigh, NC 27609

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Secondary Practice Location 1

Location 19104 Babcock Blvd, 5th FloorPittsburgh, PA 15237 · Phone (412) 863-4989 · Fax (313) 375-7225

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Absolute Total Care, Ambetter of North Carolina, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. John Thomas Nelson M.d. 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 ID6608189774

PECOS Enrollment IDI20191014000022

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.

Areas of Expertise CMS Part B claims 27

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

336 services58 patients

Chronic care management services for two or more chronic conditions, additional 20 minutes of clinical staff time directed by health care professional, per calendar month 99439

Chronic Care Management services involve regular check-ins with healthcare professionals to manage two or more chronic conditions. It includes an additional 20 minutes of clinical staff time per month, directed by a healthcare professional, to ensure optimal health management.

231 services43 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

189 services47 patients

Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg J0702

This injection contains two medications, betamethasone acetate and betamethasone sodium phosphate. It is used to reduce inflammation and pain. It's given by a healthcare professional, often directly into the area causing discomfort.

183 services64 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

175 services122 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

150 services100 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

131 services109 patients

X-ray of hand, minimum of 3 views 73130

An X-ray of the hand, minimum of 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the bones in your hand from different angles. This helps in diagnosing fractures, infections, arthritis, or other abnormalities. It's quick and painless.

106 services77 patients

Ultrasonic guidance for needle placement 76942

Ultrasonic guidance for needle placement is a technique where sound waves create images that help accurately position the needle during procedures. This method ensures precision, minimizes discomfort, and increases safety.

74 services57 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

62 services62 patients

X-ray of wrist, minimum of 3 views 73110

An X-ray of the wrist, minimum of 3 views, is a diagnostic procedure that uses radiation to create images of your wrist from different angles. This helps detect fractures, infections, or other abnormalities for accurate diagnosis and treatment planning.

56 services35 patients

Limited ultrasound scan of joint or other extremity structure except blood vessels 76882

A limited ultrasound scan of a joint or other extremity structure lacking blood vessels is a non-invasive procedure that uses sound waves to create images of the inside of your body. This helps in diagnosing and monitoring conditions related to your joints or other similar structures.

51 services39 patients

Injection into tendon or ligament 20550

An injection into a tendon or ligament involves placing medication directly into these areas to help reduce inflammation and pain. It's often used for conditions like arthritis or tendonitis. The procedure is quick and usually involves a local anesthetic.

47 services32 patients

X-ray of hand, 2 views 73120

An X-ray of the hand, 2 views, is a non-invasive imaging test that uses a small amount of radiation to produce pictures of the bones in your hand. Two different angles are captured to provide a comprehensive view. This helps in diagnosing injuries or conditions affecting your hand.

36 services27 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

36 services36 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

35 services27 patients

Release and/or relocation of hand nerve 64721

This procedure involves adjusting or moving a nerve in your hand to alleviate discomfort or improve function. The nerve may be compressed, causing pain or numbness. By releasing or relocating the nerve, these symptoms can be reduced, enhancing hand usage.

34 services33 patients

Ultrasonic guidance during surgery 76998

Ultrasonic guidance during surgery is a technique that uses sound waves to create real-time images of the inside of your body. This helps the surgeon navigate and perform procedures more accurately, reducing the risk of complications. It's like a GPS for your body's internal structures.

34 services33 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

27 services22 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

27 services22 patients

Aspiration and/or injection of fluid from small joint using ultrasound guidance 20604

This procedure involves using ultrasound to accurately locate a small joint. A needle is then carefully inserted to remove fluid (aspiration) or inject medication. This can help diagnose or treat joint issues. It's generally safe and minimally invasive.

22 services19 patients

Injection of anesthetic agent and/or steroid into suprascapular shoulder nerve 64418

This is a procedure where a medicine, often a mix of a numbing agent and a steroid, is injected into the suprascapular nerve in your shoulder. It's usually done to help manage shoulder pain, decrease inflammation, and improve mobility.

22 services18 patients

Complete ultrasound scan of joint 76881

A complete ultrasound scan of a joint is a non-invasive procedure using sound waves to create images of your joint. It helps identify problems like inflammation, injury, or disease. It's painless, safe, and doesn't involve radiation.

19 services19 patients

X-ray of elbow, minimum of 3 views 73080

An elbow X-ray with a minimum of 3 views is a non-invasive imaging test. It helps visualize the bones of the elbow from different angles. This aids in diagnosing conditions like fractures or arthritis. The procedure is quick, painless, and usually takes around 15 minutes.

17 services15 patients

Injection of drug or substance into vein 96374

This procedure involves introducing a medication or substance directly into your vein using a syringe. It's a quick and efficient way to deliver treatment throughout your body. You might feel a small prick when the needle enters. It's generally safe and effective.

16 services16 patients

Incision of tendon covering of finger 26055

This procedure involves making a small cut into the protective sheath around a finger tendon. It's typically done to relieve pressure or inflammation, improve finger movement, or treat conditions like trigger finger. It's a safe, often outpatient procedure.

14 services11 patients

Mri scan of pelvis before and after contrast 72197

An MRI scan of the pelvis before and after contrast is a non-invasive imaging technique. It uses magnetic fields and radio waves to capture detailed images of your lower abdomen. Contrast dye, safe for the body, improves image clarity. This helps detect abnormalities more accurately.

14 services14 patients

Hospital Affiliations CMS Care Compare 2

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

Duke University Hospital

Acute Care Hospitals · Durham, NC

5/5 CMS rating

OwnershipProprietary

CMS Certification Number340030

Location2100 Erwin RdDurham, NC 27705 · Durham County

Emergency services Birthing friendly

Wakemed, Raleigh Campus

Acute Care Hospitals · Raleigh, NC

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number340069

Location3000 New Bern AveRaleigh, NC 27610 · Wake County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27609 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

98.33/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

82.93

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Shoulder orthosis, acromio/clavicular (canvas and webbing type), prefabricated, off-the-shelf L3670

DME-Orthotic Devices · category DF000N

1 supplier17 claims17 services$97.20 avg. paid by Medicare

Wrist hand orthosis, wrist extension control cock-up, non molded, prefabricated, off-the-shelf L3908

DME-Orthotic Devices · category DF000N

1 supplier11 claims12 services$42.17 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

DR. DAVID T JONES MD

Orthopaedic Surgery