NPIMap

Individual provider Active NPI

Peter D Nicholas Jr., M.D.

  • Specialist
  • Wyomissing, PA
National Provider Identifier
1730185505
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD021072E Issued in PA
Practice address
2760 Century Blvd
Wyomissing, PA 19610-3359
Phone
(610) 375-4251
Fax
(610) 375-6210
NPI assigned
Jun 24, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD021072E PA Primary

Addresses

Primary practice location

2760 Century Blvd
Wyomissing, PA 19610-3359

Mailing address

2760 Century Blvd
Wyomissing, PA 19610-3359
Phone (610) 375-4251

Other identifiers 2

IdentifierTypeStateIssuer
0006369910001MedicaidPA
1730185505OtherPANPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101112000015 PA Practitioner - Rheumatology 2062423718 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Temple University School of Medicine, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
H2 Rehabilitation Extension Services LLCGroup PAC ID 6406131622, shared by 5 NPIs, 161 clinicians
Phoenix Rehabilitation and Health Services IncGroup PAC ID 3476464298, shared by 2 NPIs, 2,775 clinicians
Arthritis and Osteoporosis Center, Inc.Group PAC ID 0345223293, 7 clinicians

Practice addresses (Care Compare)

137 Montgomery Ave
Suite 205
Boyertown, PA 19512-1300
Phone (484) 658-3150

2000 Westinghouse Dr
Suite 200
Cranberry Township, PA 16066-5238

2760 Century Blvd
Suite 3
Wyomissing, PA 19610-3359
Phone (610) 375-4251

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.21 of 100Reported as individual
Quality
85.05
Promoting interoperability
99
Improvement activities
40
Cost
76.49

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD021072EPAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Arthritis and Osteoporosis Center, Inc. Specialist CurrentSince May 8, 1980 Accepting new patients
Infusion Center of Berks County PC PastSince Jul 24, 2022 Accepting new patients

Locations

401 Buttonwood St
West Reading, PA 19611
Phone (610) 375-4251

2760 Century Blvd
Wyomissing, PA 19610
Phone (610) 375-4251

2760 Century Blvd
Ste 3
Wyomissing, PA 19610
Phone (610) 375-4251

Interoperability endpoints

  • Direct secure messaging: peter.nicholas.1@3215.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/3215/brand/1/csg/1/fhir/r4

Organizations & group practices 2

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 36

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

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1119571200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1730185505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 CENTURY BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103359",
            "telephone_number": "610-375-4251",
            "fax_number": "610-375-6210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2760 CENTURY BLVD",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103359",
            "telephone_number": "610-375-4251",
            "fax_number": "610-375-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "PETER",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-24",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "PA",
            "license": "MD021072E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006369910001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1730185505",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.