GARY A NICHOLS MD
NPI 1891781803
Family Medicine in New Martinsville, WV

Q: What is Gary Nichols's NPI number?

The NPI number for Gary Nichols is 1891781803. It was assigned to this individual provider in the NPPES registry on September 26, 2005.

Q: What is Gary Nichols's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Gary Nichols was last updated on August 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.

Active since September 26, 2005PECOS EnrolledAccepts Medicare Assignment

94.1/100

CMS Quality Rating

3 E BENJAMIN DR, NEW MARTINSVILLE, WV 26155(304) 455-8080(304) 455-8141 Get Directions Write a Review

NPPES record last updated: August 11, 2020. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Gary A Nichols Md NPPES

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

GARY A NICHOLS MD (NPI 1891781803) is an individual family medicine provider in New Martinsville, West Virginia, licensed in West Virginia (21642) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Reynolds Memorial Hospital, and is a graduate of West Virginia University School Of Medicine (2001).

NPPES Registry Identity

NPI1891781803

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameGARY A NICHOLSCredential: MD

Location Address3 E BENJAMIN DRNew Martinsville, WV 26155-2705

Mailing Address3 E Benjamin DrNew Martinsville, WV 26155-2705 · (304) 455-8080 · Fax (304) 455-8141

Phone(304) 455-8080

Fax(304) 455-8141

Sole ProprietorNo

Medical School CMSWest Virginia University School Of MedicineGraduated 2001

Enumeration DateSeptember 26, 2005

Last NPPES UpdateAugust 11, 2020

NPPES CertifiedAugust 11, 2020

✔ NPI 1891781803 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in WV · 21642

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

3 E BENJAMIN DR, New Martinsville, WV 26155

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Other Identifiers 1

Medicaid3810000963WV

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource, Highmark Blue Cross Blue Shield West Virginia, Molina Healthcare.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

Gary A Nichols 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 ID9537150982

PECOS Enrollment IDI20041026001070

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 6

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.

534 services230 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

171 services171 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.

52 services44 patients

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

19 services17 patients

Transitional care management services for problem of at least moderate complexity 99495

Transitional care management services focus on coordinating and managing your care after you leave the hospital. For moderate complexity problems, this involves managing your medications, arranging further treatments, and ensuring you have the necessary follow-ups.

18 services16 patients

Physician or allowed practitioner certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians and G0180

This is a service where a doctor or authorized practitioner certifies that you require Medicare-covered home health services. They will communicate with the home health agency and review reports on your health status to ensure you receive appropriate care. This does not involve an in-person visit.

14 services12 patients

Hospital Affiliations CMS Care Compare 5

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

Reynolds Memorial Hospital

Acute Care Hospitals · Glen Dale, WV

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510013

Location800 Wheeling AveGlen Dale, WV 26038 · Marshall County

Emergency services Birthing friendly

Wheeling Hospital, Inc

Acute Care Hospitals · Wheeling, WV

1/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number510050

Location1 Medical ParkWheeling, WV 26003 · Ohio County

Emergency services Birthing friendly

Camden Clark Medical Center

Acute Care Hospitals · Parkersburg, WV

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510058

Location800 Garfield AveParkersburg, WV 26101 · Wood County

Emergency services Birthing friendly

Wetzel County Hospital

Acute Care Hospitals · New Martinsville, WV

OwnershipGovernment - Local

CMS Certification Number510072

Location#3 East Benjamin DriveNew Martinsville, WV 26155 · Wetzel County

Emergency services

Sistersville General Hospital

Critical Access Hospitals · Sistersville, WV

OwnershipVoluntary non-profit - Private

CMS Certification Number511304

Location314 South Wells StreetSistersville, WV 26175 · Tyler County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 26155 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

$83.49 typical visit price

range $53.20 – $164.59

Typical copayment $20.87 (range $13.30 – $41.14)

Most-billed visit code 99203

Established Patient

$94.81 typical visit price

range $16.47 – $133.29

Typical copayment $23.70 (range $4.11 – $33.32)

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.

94.1/100

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

Scored through an Alternative Payment Model

Quality

78.46

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 11

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

6 suppliers69 claims131 services$6.32 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

5 suppliers37 claims47 services$1.05 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers18 claims18 services$57.52 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

3 suppliers25 claims25 services$21.39 avg. paid by Medicare

Nebulizer, with compressor E0570

DME-Other DME · category DE000N

2 suppliers13 claims13 services$8.98 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers12 claims12 services$43.91 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.

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