NPIMap

Individual provider Active NPI

Peter Daniel Nicholas III, D.O.

  • Rheumatology Physician
  • Wyomissing, PA
National Provider Identifier
1740714062
Registry record updated Jul 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
OS021964 Issued in PA
Practice address
2760 Century Blvd
Wyomissing, PA 19610-3359
Phone
(610) 375-4251
Fax
(610) 685-2870
NPI assigned
Apr 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X OS021964 PA Primary
Internal Medicine Physician 207R00000X OT017580 PA

Addresses

Primary practice location

2760 Century Blvd
Wyomissing, PA 19610-3359

Mailing address

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

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
I20220725000126 PA Practitioner - Rheumatology 7416226303 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Philadelphia Col of Osteo Med, Sewanee, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
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)

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
86.35 of 100Reported as individual
Quality
90.64
Promoting interoperability
93
Improvement activities
40
Cost
69.68

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Infusion Center of Berks County PC CurrentSince Sep 1, 2022 Accepting new patients
Arthritis and Osteoporosis Center, Inc. CurrentSince Sep 1, 2022 Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: peter.nicholas.3@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 37

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

View all 37

NPI Registry JSON

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

{
    "created_epoch": "1492041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658448000000",
    "number": "1740714062",
    "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": "610-685-2870"
        },
        {
            "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": "610-685-2870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICHOLAS",
        "first_name": "PETER",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-13",
        "last_updated": "2022-07-22",
        "certification_date": "2022-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "PA",
            "license": "OS021964",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "OT017580",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyomissing, PA

Sources for this page

Verify at the official NPI Registry.