Nichole S Supple, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

274423 Issued in NY

Practice address

1425 Portland Ave
Rochester, NY 14621-3001

Phone

(585) 922-4000

NPI assigned

Jul 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nichole S Dehollander Former name

Medicare fee-for-service enrollment

Enrolled in NY, GA2 enrollments

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 2

Specialty

Emergency Medicine

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chenango Memorial Hospital IncGroup PAC ID 7517853633, 108 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Oneida Health Hospital Hospital, Oneida, NY, CCN 330115
• Chenango Memorial Hospital Hospital, Norwich, NY, CCN 330033

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nsupple30983@mvhealthsystem.direct-ci.com

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.

• Chenango Memorial Hospital Inc

  • General Acute Care Hospital
  • Norwich, NY
  • NPI 1770593956
  Medicare reassignment Care Compare group NPD
• Delphi Healthcare PLLC

  • Emergency Medicine Physician
  • Wellsville, NY
  • NPI 1003075029
  Medicare reassignment NPD
• Delphi Hospitalist Services LLC

  • Hospitalist Physician
  • Rochester, NY
  • NPI 1922270420
  Medicare reassignment NPD
• Emergency Care Services of New York, P.C.

  • Emergency Medicine Physician
  • Syracuse, NY
  • NPI 1639236656
  Medicare reassignment NPD
• Emergency Physician Services of New York, P.C.

  • Emergency Medicine Physician
  • Poughkeepsie, NY
  • NPI 1093759847
  Medicare reassignment NPD
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1770671182
  Medicare reassignment NPD
• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Oswego, NY
  • NPI 1134370547
  Medicare reassignment NPD
• Rochester General Hospital

  • Family Medicine Physician
  • Rochester, NY
  • NPI 1356412712
  Medicare reassignment NPD
• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555

  GA

  Medicare reassignment NPD
• Chenango Memorial Hospital Inc

  • Durable Medical Equipment & Medical Supplies
  • Norwich, NY
  • NPI 1437818622

  Emergency Medicine

  NPD
• Newark Wayne Community Hospital

  • General Acute Care Hospital
  • Newark, NY
  • NPI 1346369212
  NPD
• Port City Emergency Physicians LLP

  • Emergency Medicine Physician
  • Hamilton, NY
  • NPI 1316395460
  NPD

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

• Chenango Memorial Hospital Inc

  • General Acute Care Hospital
  • Norwich, NY
  • NPI 1770593956
  Care Compare affiliation
• Chenango Memorial Hospital, Inc.

  • Family Medicine Physician
  • Norwich, NY
  • NPI 1467526889

  Hospital

  Care Compare affiliation
• Oneida Health Systems, Inc

  • General Acute Care Hospital
  • Oneida, NY
  • NPI 1962408203
  Care Compare affiliation

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

{
    "created_epoch": "1278979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1871805341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 PORTLAND AVE",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146213001",
            "telephone_number": "585-922-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPPLE",
        "first_name": "NICHOLE",
        "middle_name": "S",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-13",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": "LP01965",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "274423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICHOLE",
            "last_name": "DEHOLLANDER",
            "middle_name": "S",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sunrise Transportation
• Sunshine Medical Services
• Anthony J Suozzi, M.D.
• Superior Home Care LLC
• Jay Allen Supnick, PH.D.
• Robert Steven Supple, DDS
• Elizabeth Supra, M.D.
• Audra Elizabeth Supraski, MD
• Alana Marie Surace, NP
• Laurie Surdak-Upright, C.C.C. SLP

• Emergency Medicine Physician in Rochester, NY
• Providers in Rochester, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.