DR. NATHAN DEAN NIELSEN M.D.
NPI 1780869743
Internal Medicine - Critical Care Medicine in Albuquerque, NM
Quality Rating: 85.18 out of 100 score
NPI Status: Active since January 08, 2008
Contact Information
MSC10-5550 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE, NM
ZIP 87131
Phone: (505) 272-4751
- Individual
- Male
- Internal Medicine
- Critical Care Medicine
- PECOS Enrolled
About NATHAN NIELSEN
This page provides the complete NPI Profile along with additional information for Nathan Nielsen, an internist established in Albuquerque, New Mexico with a medical specialization in Internal Medicine, focusing in critical care medicine . The healthcare provider is registered in the NPI registry with number 1780869743 assigned on January 2008. The practitioner's primary taxonomy code is 207RC0200X with license number MD2019-0746 (NM). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1780869743
- Provider Name
- DR. NATHAN DEAN NIELSEN M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- MSC10-5550 1 UNIVERSITY OF NEW MEXICO ALBUQUERQUE, NM 87131
- Location Phone
- (505) 272-4751
- Mailing Address
- 800 BRADBURY DR SE STE 116 ALBUQUERQUE, NM 87106
- Mailing Phone
- (505) 272-1476
- Is Sole Proprietor?
- No
- Enumeration Date
- 01-08-2008
- Last Update Date
- 09-26-2024
- Code Navigator
An internist like Nathan Nielsen is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Secondary Locations
- Msc10-5550 1 University Of New Mexico
Albuquerque, NM 87131
(505) 272-4751 - Msc10-5550 1 University Of New Mexico
Albuquerque, NM 87131
(505) 272-4751 - Msc10-5550 1 University Of New Mexico
Albuquerque, NM 87131
(505) 272-4751
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine Critical Care Medicine
- Taxonomy Code
- 207RC0200X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD2019-0746
- License State
- NM
- Taxonomy Description
- An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | D78283 (MD) |
| 2 | 207RC0200X | Allopathic & Osteopathic Physicians | Internal Medicine | MD.203214 (LA) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| S062-0559 | OTHER (01) | MD | CAREFIRST BC/BS |
| 1803375 | MEDICAID (05) | LA | |
| 931106800 | MEDICAID (05) | MD |
Medicare Participation & PECOS Enrollment Status
Nathan Nielsen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Blood bank physician services for cross match and/or evaluation and written report
Critical care, first 30-74 minutes
Follow-up hospital inpatient care per day, typically 35 minutes
Blood bank physician services for cross match involve testing your blood against donor blood to ensure compatibility before a transfusion. The evaluation includes a detailed analysis of your blood type and antibodies. A written report will be provided, summarizing the findings.
This service was performed 15 times for 11 patientsCritical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
This service was performed 137 times for 60 patientsFollow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
This service was performed 25 times for 22 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 87131 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $126.21
- Minimum New Patient Price $54.26
- Maximum New Patient Price $166.8
- Average New Patient Copayment $31.55
- Minimum New Patient Copayment $13.56
- Maximum New Patient Copayment $41.7
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.38
- Minimum Established Patient Price $17
- Maximum Established Patient Price $135.35
- Average Established Patient Copayment $24.09
- Minimum Established Patient Copayment $4.25
- Maximum Established Patient Copayment $33.83
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 85.18, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 85.18 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 81
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 100
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: 57.08
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: 57.08
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Reviews for DR. NATHAN DEAN NIELSEN M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1780869743, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 77. The final step is to find the difference between that total and the next multiple of ten (80 - 77 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 77 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
ALBUQUERQUE, NM 87131
ALBUQUERQUE, NM 87131
ALBUQUERQUE, NM 87131
ALBUQUERQUE, NM 87131
ALBUQUERQUE, NM 87131
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1780869743, enumerated as an "individual" on January 08, 2008.
The provider is located at MSC10-5550 1 UNIVERSITY OF NEW MEXICO ALBUQUERQUE, NM 87131 and the phone number is (505) 272-4751.
Internal Medicine with taxonomy code 207RC0200X and a focus in Critical Care Medicine.
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
