DR. NATHANIEL STEPHEN NYE MD
NPI 1982925889
Family Medicine - Sports Medicine in Cedar City, UT
NPI Status: Active since June 15, 2010
Contact Information
1303 N MAIN ST STE 3C
CEDAR CITY, UT
ZIP 84721
Phone: (435) 868-5500
- Individual
- Male
- Years of Experience 16
- Family Medicine
- Sports Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About NATHANIEL NYE
This page provides the complete NPI Profile along with additional information for Nathaniel Nye, a primary care provider established in Cedar City, Utah with a medical specialization in Family Medicine, focusing in sports medicine and more than 16 years of experience. The healthcare provider is registered in the NPI registry with number 1982925889 assigned on June 2010. The practitioner's primary taxonomy code is 207QS0010X with license number 13363898-1205 (UT). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1982925889
- Provider Name
- DR. NATHANIEL STEPHEN NYE MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1303 N MAIN ST STE 3C CEDAR CITY, UT 84721
- Location Phone
- (435) 868-5500
- Mailing Address
- PO BOX 27128 SALT LAKE CITY, UT 84127
- Medical School Name
- OTHER
- Graduation Year
- 2010
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-15-2010
- Last Update Date
- 08-26-2024
- Code Navigator
A primary care provider (PCP) like Nathaniel Nye sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
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
Family Medicine Sports Medicine
- Taxonomy Code
- 207QS0010X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 13363898-1205
- License State
- UT
- Taxonomy Description
- A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Med Benchmark Expanded Bronze Select Copay Plan - HMO
- Med Benchmark Expanded Bronze Standardized Plan - HMO
- Med Benchmark Gold Standardized Plan - HMO
- Med Benchmark Platinum - HMO
- Med Benchmark Platinum Standardized Plan - HMO
- Med Benchmark Silver 6000 Medical Deductible w/Vision - HMO
- Med Benchmark Silver Standardized Plan - HMO
- Med Gold 1500 Medical Deductible - HMO
- Signature Benchmark Gold - HMO
- Signature Benchmark Gold Standardized Plan - HMO
- Signature Benchmark Silver 5900 Medical Deductible - HMO
- Signature Benchmark Silver Standardized Plan - HMO
- Value Benchmark Expanded Bronze Select Copay Plan - HMO
- Value Benchmark Gold Standardized Plan - HMO
- Value Benchmark Platinum - HMO
- Value Benchmark Platinum Standardized Plan - HMO
- Value Benchmark Silver 5900 Medical Deductible - HMO
- Value Benchmark Silver Standardized Plan - HMO
- Value Expanded Bronze 6900 Medical Deductible - HMO
- Value Gold 1500 Medical Deductible - HMO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - EPO
- Healthy Premier Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Medicare Participation & PECOS Enrollment Status
Nathaniel Nye is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Nathaniel Nye 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
PECOS PAC ID: 547458804
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20230804000664
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.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
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $21.1 for a new patient copayment and $24.08 for an established patient copayment.
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 84721 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $84.41
- Minimum New Patient Price $54.34
- Maximum New Patient Price $166.03
- Average New Patient Copayment $21.1
- Minimum New Patient Copayment $13.58
- Maximum New Patient Copayment $41.5
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $96.35
- Minimum Established Patient Price $17.23
- Maximum Established Patient Price $135.2
- Average Established Patient Copayment $24.08
- Minimum Established Patient Copayment $4.3
- Maximum Established Patient Copayment $33.8
* 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.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nathaniel Nye is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| CEDAR CITY HOSPITAL | 1303 NORTH MAIN STREET CEDAR CITY, UT 84721 | (435) 868-5800 | Acute Care Hospitals |
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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 1982925889, we treat the final digit (9) 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 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
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 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1982925889, enumerated as an "individual" on June 15, 2010.
The provider is located at 1303 N MAIN ST STE 3C CEDAR CITY, UT 84721 and the phone number is (435) 868-5500.
Family Medicine with taxonomy code 207QS0010X and a focus in Sports Medicine.
The provider might be accepting Accepts: Select Health and University of Utah Health Plans. Please consult your insurance carrier or call the provider to verify.
Nathaniel Nye is affiliated with: CEDAR CITY HOSPITAL.
