NICOLE DANIELLE CARRILLO (RN, MS, ACNP) – Critical Care Medicine Nurse Practitioner, NPI 1114934346
Critical Care Medicine Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
16,360 NURSE PRACTITIONER in CA
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Provider Addresses for NICOLE DANIELLE CARRILLO (RN, MS, ACNP)
623 BRODERICK ST
APARTMENT A
SAN FRANCISCO, CA 941171590
Phone: (415) 921-9110
Type: Mailing
623, Broderick Street, Panhandle, San Francisco, California, 94177, United States
APARTMENT A
SAN FRANCISCO, CA 941171411
Phone: (415) 921-9110
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2023-08-16 • Largest payer in this snapshot: Chiesi USA, Inc. ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-08-16
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Chiesi USA, Inc. | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2011-05-23
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110523000010 | I | Nurse Practitioner | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 94117)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | DC | |
| Colorectal Surgery (Proctology), General Surgery | LA | |
| - | CA | |
| N E U R O S U R G E R Y | MA | |
| Internal Medicine | CA | |
| Nurse Practitioner | CA | |
| Internal Medicine | CA | |
| Emergency Medicine | CA | |
| - | MA | |
| Emergency Medicine | CA |
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