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MR. ALEXANDER ELY NICHOLSON NPP
NPI 1669737466
Nurse Practitioner - Psychiatric/Mental Health in Latham, NY

Active since July 08, 2012Opted out of Medicare · through Apr 1, 2028
711 TROY SCHENECTADY RD STE 202, LATHAM, NY 12110(518) 782-3703(518) 782-3809 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jul 21, 2022, Mar 17, 2018, Sep 1, 2017 (3 updates tracked since 2017).

About Mr. Alexander Ely Nicholson Npp NPPES

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

MR. ALEXANDER ELY NICHOLSON NPP (NPI 1669737466) is an individual psychiatric/mental health provider in Latham, New York, licensed in New York (F401487-1) and active in the NPI registry since July 2012. He has opted out of Medicare through April 1, 2028 and remains eligible to order and refer and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1669737466
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameMR. ALEXANDER ELY NICHOLSONCredential: NPP
Location Address711 TROY SCHENECTADY RD STE 202Latham, NY 12110-2461
Mailing Address711 Troy Schenectady Rd Ste 202Latham, NY 12110-2461 · (518) 782-3703 · Fax (518) 782-3809
Phone(518) 782-3703
Fax(518) 782-3809
Sole ProprietorYes
Enumeration DateJuly 8, 2012
Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration
✔ NPI 1669737466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in NY · F401487-1
711 TROY SCHENECTADY RD STE 202, Latham, NY 12110
Open in Google Maps ↗

Secondary Practice Locations 2

Location 11 West Ave Ste 205Saratoga Springs, NY 12866-6064 · Phone (518) 587-0499 · Fax (518) 587-0536
Location 22 Executive Park Dr, suite 16Albany, NY 12203-3700 · Phone (518) 438-0033 · Fax (518) 438-0055

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Mr. Alexander Ely Nicholson Npp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 1, 2016 through April 1, 2028.

Opt-Out Effective DateApril 1, 2016
Opt-Out In Effect ThroughApril 1, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12110 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$97.08 typical visit price
range $17.54 – $136.14
Typical copayment $24.27 (range $4.38 – $34.03)
Most-billed visit code 99214
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 2

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

RONNY KAFILUDDI M.D., PHD
Pain Medicine (Pain Medicine)
711 TROY SCHENECTADY RD STE 202
LATHAM, NY 12110
Albany County (518) 782-3938
HEATHER LYNN MAGGIO FNP
Nurse Practitioner (Family)
711 TROY SCHENECTADY RD STE 202
LATHAM, NY 12110
Albany County (518) 782-3938

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 Alexander Nicholson's NPI number?

The NPI number for Alexander Nicholson is 1669737466. It was assigned to this individual provider in the NPPES registry on July 8, 2012.

Where is Alexander Nicholson located?

Alexander Nicholson practices at 711 Troy Schenectady Rd Ste 202, Latham, NY 12110. The listed phone number is (518) 782-3703.

What is Alexander Nicholson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Alexander Nicholson enrolled in Medicare?

No. Alexander Nicholson has opted out of Medicare through April 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Alexander Nicholson was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.