DR. NEDRA L. RICE MD
NPI 1639354533
Obstetrics & Gynecology in Plano, TX
NPI Status: Active since January 09, 2008
Contact Information
6020 W PARKER RD STE 330
PLANO, TX
ZIP 75093
Phone: (469) 367-0225
Fax: (469) 367-0430
- Individual
- Female
- Obstetrics & Gynecology
- Accepts Insurance
- PECOS Enrolled
- Opted-Out Medicare
About NEDRA RICE
This page provides the complete NPI Profile along with additional information for Nedra Rice, a women's health care provider established in Plano, Texas with a medical specialization in Obstetrics & Gynecology. The healthcare provider is registered in the NPI registry with number 1639354533 assigned on January 2008. The practitioner's primary taxonomy code is 207V00000X with license number N5971 (TX). The provider is registered as an individual and her NPI record was last updated 3 years ago.
- NPI
- 1639354533
- Provider Name
- DR. NEDRA L. RICE MD
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 6020 W PARKER RD STE 330 PLANO, TX 75093
- Location Phone
- (469) 367-0225
- Location Fax
- (469) 367-0430
- Mailing Address
- 6020 W PARKER RD STE 330 PLANO, TX 75093
- Mailing Phone
- (469) 367-0225
- Mailing Fax
- (469) 367-0430
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-09-2008
- Last Update Date
- 07-26-2022
- Code Navigator
Women's health care providers like Nedra Rice treat and diagnose diseases and conditions that affect a woman's physical and emotional health. Women's health professionals come from a variety of different specialties, including obstetrician/gynecologists, general surgeons, perinatologists, physician assistants, nurse practitioners or nurse midwives. A women's health provider might help you with family planning, breast care, pregnancy and child birth, osteoporosis, menopause, heart disease, etc.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Nedra Rice opted out of Medicare effective on 12-19-2016 until 12-19-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
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
Obstetrics & Gynecology
- Taxonomy Code
- 207V00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- N5971
- License State
- TX
- Taxonomy Description
- An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Choice Bronze HSA - HMO
- Choice Bronze HSA + Vision + Adult Dental - HMO
- Clear Silver - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete Silver - HMO
- Complete Silver + Vision + Adult Dental - HMO
- Elite Gold - HMO
- Elite Gold + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Choice Bronze HSA (QualChoice) - POS
- Complete Gold - PPO
- Complete Gold + Vision + Adult Dental - PPO
- Complete Silver (QualChoice) - POS
- Connected Silver - PPO
- Connected Silver (QualChoice) - POS
- Connected Silver (QualChoiceLife) - PPO
- Connected Silver + Vision + Adult Dental - PPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Complete Silver - EPO
- Complete Silver + Vision + Adult Dental - EPO
- Everyday Gold - EPO
- Everyday Gold + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Elite Bronze - PPO
- Elite Bronze + Vision + Adult Dental - PPO
- Elite Gold - PPO
- Elite Gold + Vision + Adult Dental - PPO
- Everyday Bronze - PPO
- Everyday Bronze + Vision + Adult Dental - PPO
- Everyday Gold - PPO
- Everyday Gold + Vision + Adult Dental - PPO
- Focused Silver - PPO
- Focused Silver + Vision + Adult Dental - PPO
- BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Elite Gold HMO 004 (Two free PCP visits, $0 Pediatric PCP visits) - HMO
- BSW Elite Gold HMO 012 - HMO
- BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Prime Silver HMO 008 (Two free PCP visits, $0 Pediatric PCP visit) - HMO
- BSW Prime Silver HMO 005 - HMO
- BSW Savers Bronze HMO H S A 006 - HMO
- BSW Vital Bronze HMO 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
- BSW Vital Bronze HMO 009 (One free PCP visit, $0 Pediatric PCP visit) - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Silver Classic - EPO
- Silver Classic Standard - EPO
- Silver Simple PCP Saver - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 327544801 | MEDICAID (05) | TX | |
| 278831YUD | OTHER (01) | TX | MEDICARE PTAN |
Medicare Participation & PECOS Enrollment Status
Nedra Rice is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
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.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 12-19-2016
Opt-Out End Date: 12-19-2026
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
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 75093 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.4
- Minimum New Patient Price $54.84
- Maximum New Patient Price $166.88
- Average New Patient Copayment $31.6
- Minimum New Patient Copayment $13.71
- Maximum New Patient Copayment $41.72
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $68.55
- Minimum Established Patient Price $17.52
- Maximum Established Patient Price $136.11
- Average Established Patient Copayment $17.13
- Minimum Established Patient Copayment $4.38
- Maximum Established Patient Copayment $34.02
* 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.
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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 | 6 | 3 | 9 | 3 | 5 | 4 | 5 | 3 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 6 | 5 | 8 | 5 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 6 + 5 + 8 + 5 + 6 + 24 = 77 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 77 = 3 | 3 | ||||||||
The NPI number 1639354533 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 3 providers are registered at the same or nearby location.
SONY VELLAVOOR BIJI NURSE PRACTITIONER
Nurse Practitioner
(Family)
6020 W PARKER RD STE 330
PLANO, TX
ZIP 75093
CONTEMPORARY WOMEN'S CARE, PA
Obstetrics & Gynecology
6020 W PARKER RD STE 330
PLANO, TX
ZIP 75093
MICHELLE GRUNDSTROM MD
Obstetrics & Gynecology
6020 W PARKER RD STE 330
PLANO, TX
ZIP 75093
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639354533, enumerated in the NPI registry as an "individual" on January 09, 2008
The provider is located at 6020 W Parker Rd Ste 330 Plano, Tx 75093 and the phone number is (469) 367-0225
The provider's speciality is Obstetrics & Gynecology with taxonomy code 207V00000X
The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of July 06, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $126.4 with an average copayment of $31.6 for new patient appointments. Established patients should expect a typical charge of $68.55 and an average copayment of 17.13. Please review your insurance plan or contact the provider directly to determine your specific costs.
No, the provider signed an affidavit on December 19, 2016 to opt-out of the Medicare program. The provider is excluded from the Medicare program until December 19, 2026.
This NPI record was last updated on January 09, 2008. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.
