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DR. EDWARD I NELSON MD
NPI 1720085459
Pain Medicine - Pain Medicine in Cincinnati, OH

Active since July 07, 2005PECOS EnrolledAccepts Medicare Assignment
75/100
CMS Quality Rating
7691 5 MILE RD STE 10, SUITE 270, CINCINNATI, OH 45230(937) 619-3616(937) 949-4870 Get Directions Write a Review

NPPES record last updated: March 8, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Edward I Nelson Md NPPES

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

DR. EDWARD I NELSON MD (NPI 1720085459) is an individual pain medicine provider in Cincinnati, Ohio, licensed in Ohio (35092154) and active in the NPI registry since July 2005. He is enrolled in Medicare PECOS and is a graduate of Loma Linda University School Of Medicine (1985).

NPPES Registry Identity

NPI1720085459
Entity TypeIndividualMale
Primary Taxonomy208VP0000X
Provider Legal NameDR. EDWARD I NELSONCredential: MD
Location Address7691 5 MILE RD STE 10, SUITE 270Cincinnati, OH 45230-4348
Mailing AddressPo Box 638938Cincinnati, OH 45263-8938 · (937) 619-3616 · Fax (937) 949-4870
Phone(937) 619-3616
Fax(937) 949-4870
Sole ProprietorNo
Medical School CMSLoma Linda University School Of MedicineGraduated 1985
Enumeration DateJuly 7, 2005
Last NPPES UpdateMarch 8, 2017
✔ NPI 1720085459 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPain Medicine · Pain MedicineAllopathic & Osteopathic Physicians
Taxonomy Code208VP0000X
License✔ Licensed in OH · 35092154
Definition
Pain Medicine is a primary medical specialty based on a distinct body of knowledge and a well-defined scope of clinical practice that is founded on science, research and education. It is concerned with the study of pain, the prevention of pain, and the evaluation, treatment, and rehabilitation of persons in pain. A comprehensive evaluation incorporates the physical, psychological, cognitive and socio-cultural contributions to pain. The treatment protocol may include pharmacological, invasive, behavioral, cognitive, rehabilitative and complementary strategies provided in a concurrent focused and patient specific manner. The pain medicine physician often serves the patient as a frontline physician regarding their pain, but also may serve as a consultant to other physicians, direct an interdisciplinary/multidisciplinary treatment team, conduct research, or advocate for the patient's pain care with public and private agencies. The Pain Medicine physician may work in variety of settings including office, clinic, hospital, university, or governmental/public agencies.
Also ListedAnesthesiologyTaxonomy 207L00000X · License 35.092154 (OH), 34587 (KY)
Also ListedPain Medicine · Interventional Pain MedicineTaxonomy 208VP0014X · License 34587 (KY), 35-092154 (OH)
7691 5 MILE RD STE 10, Cincinnati, OH 45230
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Other Identifiers 4

Medicare PIN4247852OH
Medicare UPINF25351
Medicaid2889352OH
Medicare PINH089213OH

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MedMutual.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. Edward I Nelson Md 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 ID9931269388
PECOS Enrollment IDI20081115000088
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 12

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 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.
763 services199 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.
426 services161 patients
Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
343 services164 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0480
A definitive drug test is a detailed examination that can identify specific drugs in your system, even closely related ones. Techniques like GC/MS and LC/MS are used for high precision. This helps ensure accurate results for your safety and health.
187 services120 patients
Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml Q9967
Low osmolar contrast material with 300-399 mg/ml iodine concentration is a diagnostic tool used in imaging procedures. It helps to enhance the visibility of specific areas in the body, aiding in accurate diagnosis. It's safe and generally well-tolerated by patients.
143 services21 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0481
A definitive drug test is a detailed analysis used to identify specific drugs in your system. It uses advanced techniques, such as gc/ms and lc/ms, to detect and distinguish between different drugs, even those with similar structures.
128 services100 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45230 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
$126.12 typical visit price
range $54.34 – $166.65
Typical copayment $31.53 (range $13.58 – $41.66)
Most-billed visit code 99204
Established Patient
$96.44 typical visit price
range $17.10 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

75/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
86%1,860 patients3/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
47%1,228 patients1/55-star benchmark: 99%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
68%945 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
21%846 patients1/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients tobacco: 14% · 408 patients
19%408 patients
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
100%945 patients5/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
7%945 patients1/55-star benchmark: 89%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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 Edward Nelson's NPI number?

The NPI number for Edward Nelson is 1720085459. It was assigned to this individual provider in the NPPES registry on July 7, 2005.

Where is Edward Nelson located?

Edward Nelson practices at 7691 5 Mile Rd Ste 10 Suite 270, Cincinnati, OH 45230. The listed phone number is (937) 619-3616.

What is Edward Nelson's specialty?

The primary specialty registered for this NPI is Pain Medicine with taxonomy code 208VP0000X.

Is Edward Nelson enrolled in Medicare?

Yes. Edward Nelson 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 Edward Nelson accept?

Health plans from Anthem Blue Cross and Blue Shield and MedMutual list Edward Nelson 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.

When was this NPI record last updated?

The NPPES record for Edward Nelson was last updated on March 8, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.