Individual provider Active NPI

Gary J Nicholson, MD

  • Obstetrics & Gynecology Physician
  • Elmira, NY
National Provider Identifier
1629145768
Registry record updated Nov 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
196428 Issued in NY
Practice address
600 Fitch St Ste 102
Elmira, NY 14905-1634
Phone
(607) 734-6544
Fax
(607) 734-6580
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 196428 NY Primary

Addresses

Primary practice location

600 Fitch St Ste 102
Elmira, NY 14905-1634

Mailing address

571 Saint Josephs Blvd FL 2
Elmira, NY 14901-3230
Phone (607) 271-2050

Other identifiers 1

IdentifierTypeStateIssuer
01884977MedicaidNY

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040809000976 NY Practitioner - Obstetrics/Gynecology 5294707402 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Rochester School of Medicine and Dentistry, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arnot Ogden Medical CenterGroup PAC ID 5395798417, 219 clinicians
Arnot Medical Services PLLCGroup PAC ID 0840450748, 91 clinicians

Practice addresses (Care Compare)

100 John Roemmelt Dr
Suite 102
Horseheads, NY 14845-8302
Phone (607) 795-1666

600 Fitch St
Suite 102
Elmira, NY 14905-1634
Phone (607) 734-6544

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.64 of 100Reported as group
Quality
55.31
Promoting interoperability
99
Improvement activities
40
Cost
76.8

Merit-based Incentive Payment System (MIPS)

Final score
80.15 of 100Reported as group
Quality
46.76
Promoting interoperability
100
Improvement activities
40
Cost
77.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
196428NYMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arnot Ogden Medical Center CurrentSince Jul 1, 2023 Accepting new patients
Arnot Medical Services PLLC Obstetrics & Gynecology CurrentSince Nov 7, 2016 Accepting new patients
Ira Davenport Memorial Hospital, Inc. Current Accepting new patients
Arnot Ogden Medical Center CurrentSince Jul 1, 2023 Accepting new patients
Ira Davenport Memorial Hospital, Inc. CurrentSince Feb 1, 2024 Accepting new patients
Associates for Women'S Medicine PLLC Obstetrics & Gynecology PastSince Sep 1, 2012 Accepting new patients
Rochester General Hospital Past Accepting new patients
Bayoumi Medical PLLC Past Accepting new patients

Locations

7571 State Route 54
Bath, NY 14810
Phone (607) 776-8500

123 Conhocton St
Ste 103
Corning, NY 14830
Phone (607) 438-1200

600 Roe Ave
Elmira, NY 14905
Phone (607) 733-3639

600 Fitch St
Ste 102
Elmira, NY 14905
Phone (607) 734-6544

600 Roe Ave
Ste 1F
Elmira, NY 14905
Phone (607) 795-8161

571 Saint Josephs Blvd
Fl 2
Elmira, NY 14901
Phone (607) 271-2050

571 Saint Josephs Blvd
Ste 304
Elmira, NY 14901
Phone (607) 271-2050

100 John Roemmelt Dr
Ste 102
Horseheads, NY 14845
Phone (607) 795-1666

100 John Roemmelt Dr
Ste 202
Horseheads, NY 14845
Phone (607) 795-2820

Interoperability endpoints

  • Direct secure messaging: gary.nicholson@arn.eclinicaldirectplus.com
  • Direct secure messaging: gnicholson26513@direct.xtensys.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 8

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606262400000",
    "number": "1629145768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 SAINT JOSEPHS BLVD FL 2",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149013230",
            "telephone_number": "607-271-2050",
            "fax_number": "607-873-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 FITCH ST STE 102",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051634",
            "telephone_number": "607-734-6544",
            "fax_number": "607-734-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLSON",
        "first_name": "GARY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NY",
            "license": "196428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01884977",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.