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NIKOLINA PETRASEVIC NIELSEN DMD
NPI 1992031512
Dentist - General Practice in Sumner, WA

Active since November 02, 2009Opted out of Medicare · through Feb 2, 2027
1211 MAIN ST, SUMNER, WA 98390(253) 863-4400(206) 768-5382 Get Directions Write a Review

NPPES record last updated: August 3, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Nikolina Petrasevic Nielsen Dmd NPPES

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

NIKOLINA PETRASEVIC NIELSEN DMD (NPI 1992031512) is an individual general practice provider in Sumner, Washington, licensed in Washington (DE60146593) and active in the NPI registry since November 2009. She has opted out of Medicare through February 2, 2027.

NPPES Registry Identity

NPI1992031512
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameNIKOLINA PETRASEVIC NIELSENCredential: DMD
Location Address1211 MAIN STSumner, WA 98390-1416
Mailing Address1660 S Columbian Way, Dental ClinicSeattle, WA 98108-1532 · (206) 764-2334 · Fax (206) 768-5382
Phone(253) 863-4400
Fax(206) 768-5382
Sole ProprietorNo
Enumeration DateNovember 2, 2009
Last NPPES UpdateAugust 3, 2020
NPPES CertifiedAugust 3, 2020
✔ NPI 1992031512 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in WA · DE60146593
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1211 MAIN ST, Sumner, WA 98390
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Alabama, HRI Dental & Vision and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nikolina Petrasevic Nielsen Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from February 2, 2021 through February 2, 2027.

Opt-Out Effective DateFebruary 2, 2021
Opt-Out In Effect ThroughFebruary 2, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 98390 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
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
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.

Other Providers at the Same Location NPPES 2

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

DR. DENISE MICHELLE BEAUDET D.D.S.
Dentist (General Practice)
1211 MAIN ST
SUMNER, WA 98390
Pierce County (253) 863-4400
SUMNER SMILES DENTISTRY
Dentist
1211 MAIN ST
SUMNER, WA 98390
Pierce County (253) 863-4400

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 Nikolina Nielsen's NPI number?

The NPI number for Nikolina Nielsen is 1992031512. It was assigned to this individual provider in the NPPES registry on November 2, 2009.

Where is Nikolina Nielsen located?

Nikolina Nielsen practices at 1211 Main St, Sumner, WA 98390. The listed phone number is (253) 863-4400.

What is Nikolina Nielsen's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Nikolina Nielsen enrolled in Medicare?

No. Nikolina Nielsen has opted out of Medicare through February 2, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Nikolina Nielsen accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Alabama, HRI Dental & Vision, Humana and PacificSource Health Plans and 2 other insurers list Nikolina Nielsen 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.

When was this NPI record last updated?

The NPPES record for Nikolina Nielsen was last updated on August 3, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.