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NICOLE LYNN CARNEY D.O.
NPI 1699064584
Family Medicine in So Berwick, ME

Active since March 31, 2011PECOS EnrolledAccepts Medicare Assignment
98.06/100
CMS Quality Rating
57 PORTLAND ROAD, SO BERWICK, ME 04090(207) 384-9212(207) 384-2008 Get Directions Write a Review

NPPES record last updated: October 18, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nicole Lynn Carney D.o. NPPES

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

NICOLE LYNN CARNEY D.O. (NPI 1699064584) is an individual family medicine provider in So Berwick, Maine, licensed in Maine (DO2464) and active in the NPI registry since March 2011. She is enrolled in Medicare PECOS, is affiliated with York Hospital, and maintains a secondary practice location in Spartanburg.

NPPES Registry Identity

NPI1699064584
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameNICOLE LYNN CARNEYCredential: D.O.
Location Address57 PORTLAND ROADSo Berwick, ME 04090
Mailing Address853 N Church St Ste 510Spartanburg, SC 29303-3077
Phone(207) 384-9212
Fax(207) 384-2008
Sole ProprietorYes
Medical School CMSOtherGraduated 2011
Enumeration DateMarch 31, 2011
Last NPPES UpdateOctober 18, 2018
✔ NPI 1699064584 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ME · DO2464
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
57 PORTLAND ROAD, So Berwick, ME 04090
Open in Google Maps ↗

Secondary Practice Location 1

Location 1853 N Church St Ste 510Spartanburg, SC 29303-3077 · Phone (864) 560-7001

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Sheld, Anthem Blue Cross and Blue Shield.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

Nicole Lynn Carney D.o. 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 ID1052558798
PECOS Enrollment IDI20141027000487
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.
116 services58 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.
99 services68 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
83 services83 patients
Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
15 services11 patients

Hospital Affiliations CMS Care Compare 2

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

York Hospital

Acute Care Hospitals · York, ME
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number200020
Location15 Hospital DriveYork, ME 03909 · York County
Emergency services Birthing friendly

Wentworth-Douglass Hospital

Acute Care Hospitals · Dover, NH
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number300018
Location789 Central AveDover, NH 03820 · Strafford County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04090 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
$86.72 typical visit price
range $56.28 – $169.96
Typical copayment $21.68 (range $14.07 – $42.49)
Most-billed visit code 99203
Established Patient
$99.18 typical visit price
range $18.22 – $138.92
Typical copayment $24.79 (range $4.55 – $34.73)
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.

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.

98.06/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality86.13
Promoting Interoperability100
Improvement Activities40

Referred Medical Equipment & Supplies CMS DME claims 6

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

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers11 claims40 services$7.01 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers11 claims11 services$39.67 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
2 suppliers12 claims12 services$93.88 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
2 suppliers13 claims39 services$34.78 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
2 suppliers16 claims96 services$2.32 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers11 claims11 services$82.80 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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 Nicole Carney's NPI number?

The NPI number for Nicole Carney is 1699064584. It was assigned to this individual provider in the NPPES registry on March 31, 2011.

Where is Nicole Carney located?

Nicole Carney practices at 57 Portland Road, So Berwick, ME 04090. The listed phone number is (207) 384-9212.

What is Nicole Carney's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Nicole Carney enrolled in Medicare?

Yes. Nicole Carney is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Nicole Carney accept?

Health plans from Ambetter from NH Healthy Families, Anthem Blue Cross and Blue Sheld and Anthem Blue Cross and Blue Shield list Nicole Carney as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Nicole Carney affiliated with any hospitals?

According to CMS data, Nicole Carney is affiliated with York Hospital and Wentworth-Douglass Hospital.

When was this NPI record last updated?

The NPPES record for Nicole Carney was last updated on October 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.