DR. NIKOS KONSTANTINOS PAVLIDES MD
NPI 1891726006
Orthopaedic Surgery in Pottstown, PA

Q: What is Nikos Pavlides's NPI number?

The NPI number for Nikos Pavlides is 1891726006. It was assigned to this individual provider in the NPPES registry on July 5, 2006.

Q: What is Nikos Pavlides's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Nikos Pavlides was last updated on November 26, 2013. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 05, 2006PECOS EnrolledAccepts Medicare Assignment

59.36/100

CMS Quality Rating

1561 MEDICAL DR, POTTSTOWN, PA 19464(610) 792-9292(610) 792-9292 Get Directions Write a Review

NPPES record last updated: November 26, 2013. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Dr. Nikos Konstantinos Pavlides Md NPPES

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

DR. NIKOS KONSTANTINOS PAVLIDES MD (NPI 1891726006) is an individual orthopaedic surgery provider in Pottstown, Pennsylvania, licensed in Pennsylvania (430394) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS, is affiliated with Pottstown Hospital, and is a graduate of Hahnemann University College Of Medicine (2001).

NPPES Registry Identity

NPI1891726006

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDR. NIKOS KONSTANTINOS PAVLIDESCredential: MD

Location Address1561 MEDICAL DRPottstown, PA 19464-3218

Mailing Address1561 Medical DrPottstown, PA 19464-3218 · (610) 792-9292 · Fax (610) 792-9292

Phone(610) 792-9292

Fax(610) 792-9292

Sole ProprietorNo

Medical School CMSHahnemann University College Of MedicineGraduated 2001

Enumeration DateJuly 5, 2006

Last NPPES UpdateNovember 26, 2013

✔ NPI 1891726006 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

License✔ Licensed in PA · 430394

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

1561 MEDICAL DR, Pottstown, PA 19464

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Other Identifiers 1

Medicare UPINI57204

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield Delaware.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. Nikos Konstantinos Pavlides 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 ID8628072501

PECOS Enrollment IDI20070724000315

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 22

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

3,012 services206 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.

668 services402 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

444 services249 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

329 services235 patients

Hyaluronan or derivative, gel-one, for intra-articular injection, per dose J7326

Hyaluronan or Gel-One is a substance injected directly into your joint space. It's aimed to supplement your body's natural joint fluid, helping to lubricate and cushion the joint, reducing pain and improving mobility. It's often used for arthritis relief.

267 services166 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.

161 services149 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

146 services114 patients

Aspiration and/or injection of fluid large joint using ultrasound guidance 20611

This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.

144 services99 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

120 services120 patients

Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222

Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.

58 services56 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

50 services38 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

45 services44 patients

Replacement of knee joint, both sides of knee 27447

42 services42 patients

Hyaluronan or derivative, monovisc, for intra-articular injection, per dose J7327

Monovisc is a treatment involving an injection of hyaluronan or its derivative into a joint, often the knee. This substance, found naturally in joint fluid, helps lubricate and cushion the joint. The injection can help ease pain, improve mobility, and reduce inflammation caused by arthritis.

38 services23 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

34 services34 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

30 services26 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

28 services27 patients

Replacement of thigh bone and hip joint with prosthesis 27130

19 services19 patients

Principal care management services for a single high-risk disease, first 30 minutes of clinical staff time directed by health care professional, per calendar month 99426

Principal care management services focus on managing a single high-risk disease. This involves a health care professional directing clinical staff for the first 30 minutes each month. The aim is to monitor your health, coordinate care, and provide necessary support for your disease management.

19 services19 patients

Mri scan of lower spinal canal without contrast 72148

An MRI scan of the lower spinal canal without contrast is a non-invasive imaging test. It uses a magnetic field and radio waves to produce detailed images of your lower spine. This helps identify issues like disc problems, tumors, or nerve conditions. No dye is used.

15 services15 patients

X-ray of both hips, 3-4 views 73522

An X-ray of both hips with 3-4 views is a safe imaging procedure. It involves capturing multiple pictures of your hip joints from different angles. This helps in diagnosing conditions like arthritis or fractures. You'll need to stay still during the process for clear images.

15 services15 patients

X-ray of lower and sacral spine, minimum of 4 views 72110

An X-ray of the lower and sacral spine involves capturing images of your lower back and tailbone area. It helps in identifying issues like fractures, arthritis, or other abnormalities. At least four different angles or 'views' are taken to get a comprehensive picture.

11 services11 patients

Hospital Affiliations CMS Care Compare 2

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

Pottstown Hospital

Acute Care Hospitals · Pottstown, PA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390123

Location1600 East High StreetPottstown, PA 19464 · Montgomery County

Emergency services

Phoenixville Hospital

Acute Care Hospitals · Phoenixville, PA

3/5 CMS rating

OwnershipProprietary

CMS Certification Number390127

Location140 Nutt RoadPhoenixville, PA 19460 · Chester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19464 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

Most-billed visit code 99213

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.

59.36/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Individually scored

Quality

52.38

Improvement Activities

Cost

51.83

Reported Quality Measures

Colorectal Cancer Screening

0%1,080 patients1/55-star benchmark: 88%

Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)

Lower rates are better for this measure.

100%23 patients1/55-star benchmark: 91%

Documentation of Current Medications in the Medical Record

95%4,447 patients4/55-star benchmark: 100%

Falls: Screening for Future Fall Risk

33%921 patients2/55-star benchmark: 100%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

0%2,477 patients1/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients combinedPopulations: 53% · 1,693 patients

Patients screened: 53% · 1,693 patients

45%20 patients2/55-star benchmark: 100%

Risk-standardized complication rate (RSCR) following elective primary total hip arthroplasty (THA) and/or total knee arthroplasty (TKA) for Merit-based Incentive Payment System (MIPS)

Lower rates are better for this measure.

0.04%

Statin Therapy for the Prevention and Treatment of Cardiovascular Disease

89%193 patients4/55-star benchmark: 91%

Use of High-Risk Medications in Older Adults

Lower rates are better for this measure.

Patients appropriateDiagnosis: 0% · 941 patients

Patients totalRate: 1% · 941 patients

1%941 patients4/55-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

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

Walker, folding, wheeled, adjustable or fixed height E0143

DME-Other DME · category DE000N

6 suppliers13 claims13 services$43.83 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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Other Providers at the Same Location NPPES 12

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

BRANDYWINE INSTITUTE OF ORTHOPAEDICS, P.C.

Orthopaedic Surgery