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DR. MICHAEL E NELSON MD
NPI 1821026295
Internal Medicine in Athens, GA

Active since June 28, 2006PECOS EnrolledAccepts Medicare Assignment
91.65/100
CMS Quality Rating
1500 OGLETHORPE AVE, SUITE 2200, ATHENS, GA 30606(706) 543-0471(706) 543-6091 Get Directions Write a Review

NPPES record last updated: June 22, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Michael E Nelson Md NPPES

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

DR. MICHAEL E NELSON MD (NPI 1821026295) is an individual internal medicine provider in Athens, Georgia, licensed in Georgia (054406) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS, is affiliated with Piedmont Athens Regional Medical Center, and is a graduate of Medical College Of Georgia School Of Medicine (2000).

NPPES Registry Identity

NPI1821026295
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. MICHAEL E NELSONCredential: MD
Location Address1500 OGLETHORPE AVE, SUITE 2200Athens, GA 30606-2179
Mailing Address1500 Oglethorpe Ave, Suite 2200Athens, GA 30606-2179 · (706) 543-0471 · Fax (706) 543-6091
Phone(706) 543-0471
Fax(706) 543-6091
Sole ProprietorNo
Medical School CMSMedical College Of Georgia School Of MedicineGraduated 2000
Enumeration DateJune 28, 2006
Last NPPES UpdateJune 22, 2010
✔ NPI 1821026295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 054406
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPediatricsTaxonomy 208000000X · License 054406 (GA)
1500 OGLETHORPE AVE, Athens, GA 30606
Open in Google Maps ↗

Other Identifiers 5

Medicare UPINI07853GA
Medicaid624289802BGA
Medicaid624289802CGA
Medicare ID-Type Unspecified11SCCVJGA
Medicaid624289802AGA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.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. Michael E 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 ID2668451444
PECOS Enrollment IDI20040715000748
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.
73 services35 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.
33 services24 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
14 services14 patients
Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
14 services14 patients

Hospital Affiliations CMS Care Compare

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

Piedmont Athens Regional Medical Center

Acute Care Hospitals · Athens, GA
4/5 CMS rating
OwnershipVoluntary non-profit - Other
CMS Certification Number110074
Location1199 Prince AvenueAthens, GA 30606 · Clarke County
Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30606 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
$124.10 typical visit price
range $53.31 – $164.04
Typical copayment $31.02 (range $13.32 – $41.01)
Most-billed visit code 99204
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

91.65/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Promoting Interoperability99
Improvement Activities20

Reported Quality Measures

Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
37%27 patients2/55-star benchmark: 100%
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%34 patients1/55-star benchmark: 100%
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.

Referred Medical Equipment & Supplies CMS DME claims 8

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
5 suppliers13 claims21 services$6.38 avg. paid by Medicare
Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
2 suppliers16 claims16 services$31.53 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
3 suppliers11 claims64 services$20.66 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers14 claims14 services$49.89 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers12 claims72 services$2.28 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
1 supplier14 claims14 services$15.45 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

DR. JEANNE M MARTIN MD
Pediatrics
1500 OGLETHORPE AVE, STE. 2500
ATHENS, GA 30606
Clarke County (706) 548-7909
ROBERT BERNARD WARD JR. D.D.S.
Dentist (General Practice)
1500 OGLETHORPE AVE, SUITE 2300
ATHENS, GA 30606
Clarke County (706) 546-8407
KRISTEN NICOLE KISER PTA
Physical Therapy Assistant
1500 OGLETHORPE AVE, BLDG 500
ATHENS, GA 30606
Clarke County (706) 549-9244
ATHENS REGIONAL SPECIALTY SERVICES
Family Medicine
1500 OGLETHORPE AVE, STE 600A
ATHENS, GA 30606
Clarke County (706) 475-4920
CHILDRENS THERAPY CENTER
Speech-Language Pathologist
1500 OGLETHORPE AVE, SUITE 500 D
ATHENS, GA 30606
Clarke County (706) 353-3573
LEE CHISOLM MD
Family Medicine
1500 OGLETHORPE AVE, SUITE 3300
ATHENS, GA 30606
Clarke County (706) 208-1406
STEPHANIE JOHNSON NP
Urology
1500 OGLETHORPE AVE, SUITE 2000
ATHENS, GA 30606
Clarke County (706) 543-6261
MARTIN KAGIRA M.D
Student in an Organized Health Care Education/Training Program
1500 OGLETHORPE AVE, SUITE 200D
ATHENS, GA 30606
Clarke County (706) 389-3875

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 Michael Nelson's NPI number?

The NPI number for Michael Nelson is 1821026295. It was assigned to this individual provider in the NPPES registry on June 28, 2006.

Where is Michael Nelson located?

Michael Nelson practices at 1500 Oglethorpe Ave Suite 2200, Athens, GA 30606. The listed phone number is (706) 543-0471.

What is Michael Nelson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Michael Nelson enrolled in Medicare?

Yes. Michael 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 Michael Nelson accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Michael 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.

Is Michael Nelson affiliated with any hospitals?

According to CMS data, Michael Nelson is affiliated with Piedmont Athens Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Michael Nelson was last updated on June 22, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.