1. Home
  2. Directory
  3. Ohio
  4. Columbus
  5. Pediatrics
  6. NPI Profile

JACQUELINE NICODEMO
NPI 1750886115
Pediatrics in Columbus, OH

Active since March 28, 2018PECOS Enrolled
700 CHILDRENS DR, COLUMBUS, OH 43205(614) 722-4411 Get Directions Write a Review

NPPES record last updated: June 26, 2018. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 26, 2018, Mar 28, 2018 (2 updates tracked since 2018).

About Jacqueline Nicodemo NPPES

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

JACQUELINE NICODEMO (NPI 1750886115) is an individual pediatrics provider in Columbus, Ohio, licensed in Ohio (57.246584) and active in the NPI registry since March 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1750886115
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameJACQUELINE NICODEMO
Location Address700 CHILDRENS DRColumbus, OH 43205
Mailing Address700 Childrens DrColumbus, OH 43205-2664 · (614) 722-4411
Phone(614) 722-4411
Sole ProprietorNo
Enumeration DateMarch 28, 2018
Last NPPES UpdateJune 26, 20182 updates tracked since enumeration
✔ NPI 1750886115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in OH · 57.246584
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
700 CHILDRENS DR, Columbus, OH 43205
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Nicodemo is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Jacqueline Nicodemo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pediatric Academic Association, Inc.
Same address
Pediatrics
700 CHILDRENS DR
Columbus, OH 43205
  • Reassigned Medicare billing, Ohio enrollment
  • 1,246 clinicians in this Medicare group
NPI 1063419943 (614) 722-4579

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43205 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
$84.72 typical visit price
range $54.34 – $166.65
Typical copayment $21.18 (range $13.58 – $41.66)
Most-billed visit code 99203
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.

Other Providers at the Same Location NPPES 20

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

BELA M GANDHI MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
700 CHILDRENS DR
COLUMBUS, OH 43205
Franklin County (614) 722-8212
AMRIK SINGH KHALSA M.D.
Pediatrics
700 CHILDRENS DR
COLUMBUS, OH 43205
Franklin County (614) 722-2000
DR. ROBERT MICHAEL DORMAN M.D.
Surgery
700 CHILDRENS DR, CCPR
COLUMBUS, OH 43205
Franklin County (614) 722-0449
MR. CHRISTOPHER JONES MD
Pediatrics (Pediatric Emergency Medicine)
700 CHILDRENS DR
COLUMBUS, OH 43205
Franklin County (614) 722-2000
LEANNE MURRAY PHARMD
Pharmacist
700 CHILDRENS DR
COLUMBUS, OH 43205
Franklin County (614) 722-2160
CLAIRE ELIZABETH CHRISTIAN M.D.
Pediatrics (Pediatric Emergency Medicine)
700 CHILDRENS DR
COLUMBUS, OH 43205
Franklin County (614) 722-2000
MEGAN MCNICOL
Pharmacist
700 CHILDRENS DR
COLUMBUS, OH 43205
Franklin County (614) 722-2160
MARIA STRENG
Nurse Practitioner (Pediatrics)
700 CHILDRENS DR
COLUMBUS, OH 43205
Franklin County (614) 722-2000

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 Jacqueline Nicodemo's NPI number?

The NPI number for Jacqueline Nicodemo is 1750886115. It was assigned to this individual provider in the NPPES registry on March 28, 2018.

Where is Jacqueline Nicodemo located?

Jacqueline Nicodemo practices at 700 Childrens Dr, Columbus, OH 43205. The listed phone number is (614) 722-4411.

What is Jacqueline Nicodemo's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Jacqueline Nicodemo enrolled in Medicare?

Yes. Jacqueline Nicodemo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jacqueline Nicodemo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jacqueline Nicodemo reassigns Medicare benefits to Pediatric Academic Association, Inc. (Columbus, OH). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jacqueline Nicodemo's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jacqueline Nicodemo accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual and UnitedHealthcare list Jacqueline Nicodemo 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 Jacqueline Nicodemo was last updated on June 26, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.