NICOLE PAOLA MATHES MD
NPI 1023302007
Family Medicine in Broken Arrow, OK
NPI Status: Active since June 07, 2011
Contact Information
800 W BOISE CIR STE 160
BROKEN ARROW, OK
ZIP 74012
Phone: (918) 994-9166
Fax: (918) 403-6306
- Individual
- Female
- Years of Experience 15
- Family Medicine
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About NICOLE MATHES
This page provides the complete NPI Profile along with additional information for Nicole Mathes, a primary care provider established in Broken Arrow, Oklahoma with a medical specialization in Family Medicine and more than 15 years of experience. She graduated from University Of Texas Southwestern Medical School At Dallas in 2011. The healthcare provider is registered in the NPI registry with number 1023302007 assigned on June 2011. The practitioner's primary taxonomy code is 207Q00000X with license number S3238 (TX). The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1023302007
- Provider Name
- NICOLE PAOLA MATHES MD
- Other Name
- NICOLE VERA
- Other Name Type
- Former Name (1)
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 800 W BOISE CIR STE 160 BROKEN ARROW, OK 74012
- Location Phone
- (918) 994-9166
- Location Fax
- (918) 403-6306
- Mailing Address
- 1923 S UTICA AVE TULSA, OK 74104
- Mailing Phone
- (918) 403-7065
- Mailing Fax
- (918) 403-6306
- Medical School Name
- UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL SCHOOL AT DALLAS
- Graduation Year
- 2011
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-07-2011
- Last Update Date
- 01-08-2025
- Code Navigator
A primary care provider (PCP) like Nicole Mathes sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- S3238
- License State
- TX
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze PPO? 202 - PPO
- Blue Advantage Bronze PPO? 203 - PPO
- Blue Advantage Bronze PPO? Standard - PPO
- Blue Advantage Gold PPO? 309 - PPO
- Blue Advantage Gold PPO? 604 - PPO
- Blue Advantage Gold PPO? Standard - PPO
- Blue Advantage Silver PPO? 204 - PPO
- Blue Advantage Silver PPO? 501 - PPO
- Blue Advantage Silver PPO? Standard - PPO
- Blue Preferred Bronze PPO? Standard - PPO
- Blue Preferred Gold PPO? Standard - PPO
- Blue Preferred Security PPO? 200 - PPO
- Blue Preferred Silver PPO? Standard - PPO
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 12 - HMO
- Gold 8 - HMO
- Gold 8 with Rx Copay - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 1 with Rx Copay and Adult Vision Services - HMO
- Silver 12 with first 4 free PCP or MH visits - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- TARO Direct Primary Care Bronze 4150 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
- TARO Direct Primary Care Gold $0 Ded ($0 DPC + $0 PCP + $0 Mental Health) - HMO
- TARO Direct Primary Care Silver 1900 ($0 DPC + $0 PCP + $0 Mental Health) - HMO
- TARO Standard Bronze (No Direct Primary Care, for DPC select DPC Bronze) - HMO
- TARO Standard Gold (No Direct Primary Care, for DPC select DPC Gold) - HMO
- TARO Standard Silver (No Direct Primary Care, for DPC select DPC Silver) - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 427183501 | MEDICAID (05) | TX | |
| 427183502 | MEDICAID (05) | TX | |
| 201278690A | MEDICAID (05) | OK |
Medicare Participation & PECOS Enrollment Status
Nicole Mathes is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Nicole Mathes is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 5698179026
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20240813001715
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Physician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $20.61 for a new patient copayment and $23.56 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 74012 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $82.46
- Minimum New Patient Price $53
- Maximum New Patient Price $162.61
- Average New Patient Copayment $20.61
- Minimum New Patient Copayment $13.25
- Maximum New Patient Copayment $40.65
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $94.27
- Minimum Established Patient Price $16.68
- Maximum Established Patient Price $132.4
- Average Established Patient Copayment $23.56
- Minimum Established Patient Copayment $4.17
- Maximum Established Patient Copayment $33.1
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Nicole Mathes is affiliated with the following medical facilities:
| Hospital Name | Address | Phone | Hospital Type | Overall Rating |
|---|---|---|---|---|
| ASCENSION ST JOHN MEDICAL CENTER | 1923 SOUTH UTICA AVENUE TULSA, OK 74104 | (918) 744-3131 | Acute Care Hospitals | |
| ASCENSION ST JOHN BROKEN ARROW | 1000 WEST BOISE CIRCLE BROKEN ARROW, OK 74012 | (918) 994-8100 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 2 | 3 | 3 | 0 | 2 | 0 | 0 | 7 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 4 | 3 | 6 | 0 | 4 | 0 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 4 + 3 + 6 + 0 + 4 + 0 + 0 + 24 = 43 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 43 = 7 | 7 | ||||||||
The NPI number 1023302007 is valid because the calculated check digit 7 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 5 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1427033620 | ANTHONY BARBETTINI PA-C Individual | Physician Assistant | 800 W BOISE CIR STE 160 BROKEN ARROW, OK 74012 (918) 994-9130 |
| 1912975012 | ROBERT NIEBERGALL MD Individual | Internal Medicine | 800 W BOISE CIR STE 160 BROKEN ARROW, OK 74012 (918) 994-9160 |
| 1083646541 | ROBERT JEFFREY WRIGHT DO Individual | Family Medicine | 800 W BOISE CIR STE 160 BROKEN ARROW, OK 74012 (918) 994-9160 |
| 1356799142 | JENNIFER JANETTE VANDERFORD APRN NP-C Individual | Nurse Practitioner (Family) | 800 W BOISE CIR STE 160 BROKEN ARROW, OK 74012 (918) 994-9160 |
| 1396253043 | CORINNE ONIGBINDE PA-C Individual | Physician Assistant | 800 W BOISE CIR STE 160 BROKEN ARROW, OK 74012 (918) 994-9160 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1023302007, enumerated in the NPI registry as an "individual" on June 07, 2011
The provider is located at 800 W Boise Cir Ste 160 Broken Arrow, Ok 74012 and the phone number is (918) 994-9166
The provider's speciality is Family Medicine with taxonomy code 207Q00000X
The provider has more than 15 years of experience. She graduated from University Of Texas Southwestern Medical School At Dallas in 2011.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Oklahoma, Molina. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $82.46 with an average copayment of $20.61 for new patient appointments. Established patients should expect a typical charge of $94.27 and an average copayment of 23.56. Please review your insurance plan or contact the provider directly to determine your specific costs.
The practitioner is affiliated to the following hospital(s): ASCENSION ST JOHN MEDICAL CENTER and ASCENSION ST JOHN BROKEN ARROW. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.
This NPI record was last updated on June 07, 2011. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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