Individual provider Active NPI

Shari L Nichols, DPM

  • Podiatrist
  • Binghamton, NY
National Provider Identifier
1154323194
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
N005456 Issued in NY
Practice address
65 Pennsylvania Ave
Suite 200
Binghamton, NY 13903-1651
Phone
(607) 772-8772
Fax
(607) 772-8796
NPI assigned
Aug 10, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N005456 NY Primary

Addresses

Primary practice location

65 Pennsylvania Ave
Suite 200
Binghamton, NY 13903-1651

Mailing address

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

Other identifiers 1

IdentifierTypeStateIssuer
01901880MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100302000080 NY Practitioner - Podiatry 5890830954 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Des Moines University of Osteopathic Medicine and Health Sciences, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4433 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 771-2220

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.14 of 100Reported as group
Quality
86.74
Promoting interoperability
99
Improvement activities
40
Cost
70.09

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue389
Removal of nail tissue32
Removal or shaving of skin growth23

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
N005456NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates, P.C. CurrentSince Jan 1, 1999 Accepting new patients
United Medical Associates PC CurrentSince Jan 1, 1999 Accepting new patients

Locations

65 Pennsylvania Ave
Ste 200
Binghamton, NY 13903
Phone (607) 772-8772

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

4433 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 762-2176

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1154323194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "346 GRAND AVE",
            "city": "JOHNSON CITY",
            "state": "NY",
            "postal_code": "13790",
            "telephone_number": "607-729-8156",
            "fax_number": "607-729-3982"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 PENNSYLVANIA AVE",
            "address_2": "SUITE 200",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139031651",
            "telephone_number": "607-772-8772",
            "fax_number": "607-772-8796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLS",
        "first_name": "SHARI",
        "middle_name": "L",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N005456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01901880",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.