COURTNEY N NICHOLSON PA-C
NPI 1649852138
Physician Assistant in Jacksonville, FL

Q: What is Courtney Nicholson's NPI number?

The NPI number for Courtney Nicholson is 1649852138. It was assigned to this individual provider in the NPPES registry on April 23, 2021.

Q: What is Courtney Nicholson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since April 23, 2021PECOS EnrolledAccepts Medicare Assignment

91.62/100

CMS Quality Rating

14540 OLD SAINT AUGUSTINE RD STE 2201, JACKSONVILLE, FL 32258(904) 880-9696(904) 390-7452 Get Directions Write a Review

NPPES record last updated: April 14, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Apr 14, 2023, May 12, 2021, Apr 23, 2021 (3 updates tracked since 2021).

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About Courtney N Nicholson Pa-c NPPES

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

COURTNEY N NICHOLSON PA-C (NPI 1649852138) is an individual physician assistant in Jacksonville, Florida, licensed in Florida (PA9114339) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS, is affiliated with Baptist Health Medical Center - Jacksonville, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1649852138

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameCOURTNEY N NICHOLSONCredential: PA-C

Location Address14540 OLD SAINT AUGUSTINE RD STE 2201Jacksonville, FL 32258-7418

Mailing AddressPo Box 746638Atlanta, GA 30374-6638 · (904) 202-1032 · Fax (904) 376-4107

Phone(904) 880-9696

Fax(904) 390-7452

Sole ProprietorNo

Medical School CMSOtherGraduated 2021

Enumeration DateApril 23, 2021

Last NPPES UpdateApril 14, 20233 updates tracked since enumeration

NPPES CertifiedApril 14, 2023

✔ NPI 1649852138 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in FL · PA9114339

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Also ListedPhysician Assistant · MedicalTaxonomy 363AM0700X · License PA9114339 (FL)

14540 OLD SAINT AUGUSTINE RD STE 2201, Jacksonville, FL 32258

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AvMed.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

Courtney N Nicholson Pa-c 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 ID2567871197

PECOS Enrollment IDI20210511001230

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 4

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.

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.

897 services501 patients

Continuous monitoring of blood sugar level in tissue fluid using sensor under skin with interpretation and report 95251

This procedure involves placing a small sensor under your skin to continuously monitor your blood sugar levels in tissue fluid. The data is interpreted and a report is generated to help manage your diabetes more effectively.

173 services87 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

97 services71 patients

Blood glucose (sugar) test performed by hand-held instrument 82962

A blood glucose test uses a handheld device to measure the amount of sugar in your blood. A small prick on your finger allows a drop of blood to be placed on a test strip, which is then read by the device. This helps monitor and manage diabetes effectively.

81 services68 patients

Hospital Affiliations CMS Care Compare 5

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

Baptist Health Medical Center - Jacksonville

Acute Care Hospitals · Jacksonville, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100088

Location800 Prudential DrJacksonville, FL 32207 · Duval County

Emergency services Birthing friendly

Flagler Hospital

Acute Care Hospitals · Saint Augustine, FL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100090

Location400 Health Park BlvdSaint Augustine, FL 32086 · St. Johns County

Emergency services Birthing friendly

Baptist Medical Center Beaches

Acute Care Hospitals · Jacksonville Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100117

Location1350 13th Ave SJacksonville Beach, FL 32250 · Duval County

Emergency services Birthing friendly

Ed Fraser Memorial Hospital

Acute Care Hospitals · Macclenny, FL

OwnershipVoluntary non-profit - Private

CMS Certification Number100134

Location159 N 3rd StMacclenny, FL 32063 · Baker County

Emergency services

Baptist Medical Center - Nassau

Acute Care Hospitals · Fernandina Beach, FL

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number100140

Location1250 S 18th StFernandina Beach, FL 32034 · Nassau County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32258 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

$87.62 typical visit price

range $56.00 – $171.84

Typical copayment $21.90 (range $14.00 – $42.96)

Most-billed visit code 99203

Established Patient

$70.04 typical visit price

range $17.57 – $139.16

Typical copayment $17.51 (range $4.39 – $34.79)

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.

91.62/100

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

Scored through an Alternative Payment Model

Quality

77.61

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 5

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

Supplies for external insulin infusion pump, syringe type cartridge, sterile, each A4225

DME-Other DME · category DE017N

4 suppliers14 claims500 services$2.37 avg. paid by Medicare

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

14 suppliers39 claims135 services$6.65 avg. paid by Medicare

Insulin for administration through dme (i.e., insulin pump) per 50 units J1817

Treatment-Injections and Infusions (nononcologic) · category RI000N

6 suppliers11 claims1,820 services$6.72 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

7 suppliers218 claims218 services$183.66 avg. paid by Medicare

Receiver (monitor), dedicated, for use with therapeutic glucose continuous monitor system K0554

DME-Other DME · category DE017N

3 suppliers15 claims15 services$204.55 avg. paid by Medicare

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

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Other Providers at the Same Location NPPES 7

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

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Nurse Practitioner