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DR. CHARLES M NIETO M.D.
NPI 1992785653
Internal Medicine in Ridgeville, SC

Active since January 19, 2006PECOS Enrolled
4789 STATE RD, RIDGEVILLE, SC 29472(843) 688-5311 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 21, 2022, Jul 30, 2018, Mar 17, 2018 and 1 more (4 updates tracked since 2017).

About Dr. Charles M Nieto M.d. NPPES

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

DR. CHARLES M NIETO M.D. (NPI 1992785653) is an individual internal medicine provider in Ridgeville, South Carolina, licensed in New York (218850) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Aurora.

NPPES Registry Identity

NPI1992785653
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. CHARLES M NIETOCredential: M.D.
Location Address4789 STATE RDRidgeville, SC 29472-6921
Mailing Address2960 Tongass AveKetchikan, AK 99901-5742 · (907) 228-4900 · Fax (907) 228-4905
Phone(843) 688-5311
Sole ProprietorNo
Enumeration DateJanuary 19, 2006
Last NPPES UpdateJuly 21, 20224 updates tracked since enumeration
✔ NPI 1992785653 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Licenses✔ Licensed in NY · 218850✔ Licensed in CO · DR44149
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.
4789 STATE RD, Ridgeville, SC 29472
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Secondary Practice Location 1

Location 11360 S Potomac StAurora, CO 80012-4505 · Phone (303) 337-5575 · Fax (303) 745-6264

Other Identifiers 1

Medicaid44929064CO

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Charles M Nieto M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignments

2

Medicare enrollment records show Charles Nieto reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hudson Valley Radiology Associates PLLC
647 mi
Diagnostic Radiology
18 SQUADRON BLVD
New City, NY 10956
  • Reassigned Medicare billing, New York enrollment
  • 210 clinicians in this Medicare group
NPI 1174574115 (845) 634-9729
Ketchikan Indian Corporation
2,879 mi
Primary Care
2960 TONGASS AVE, BUSINESS OFFICE
Ketchikan, AK 99901
  • Reassigned Medicare billing, Texas enrollment
  • 33 clinicians in this Medicare group
NPI 1821120486 (907) 228-9200

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 29472 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
$124.04 typical visit price
range $53.57 – $163.84
Typical copayment $31.01 (range $13.39 – $40.96)
Most-billed visit code 99204
Established Patient
$95.12 typical visit price
range $16.96 – $133.52
Typical copayment $23.78 (range $4.24 – $33.38)
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.

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 Charles Nieto's NPI number?

The NPI number for Charles Nieto is 1992785653. It was assigned to this individual provider in the NPPES registry on January 19, 2006.

Where is Charles Nieto located?

Charles Nieto practices at 4789 State Rd, Ridgeville, SC 29472. The listed phone number is (843) 688-5311.

What is Charles Nieto's specialty?

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

Is Charles Nieto enrolled in Medicare?

Yes. Charles Nieto is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Charles Nieto's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Charles Nieto reassigns Medicare benefits to 2 organizations: Hudson Valley Radiology Associates PLLC (New City, NY) and Ketchikan Indian Corporation (Ketchikan, AK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Charles Nieto's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Charles Nieto was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.