KRISTA TICKEMYER (FNP) – Nurse Practitioner, NPI 1114393618
Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
1,802 NURSE PRACTITIONER in ID
Provider Addresses for KRISTA TICKEMYER (FNP)
1090 W. Park Place
Coeur d'Alene, ID 83814
Phone: (208) 292-0292
Fax: (208) 292-0705
Type: Location
2003 KOOTENAI HEALTH WAY
COEUR D ALENE, ID 838146051
Phone: (208) 625-5059
Fax: (208) 625-5731
Type: Mailing
1919 LINCOLN WAY STE 415
COEUR D ALENE, ID 83814
Phone: (208) 625-4595
Fax: (208) 625-4596
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 77 Open Payments records for all available years, with a total value of $2,487.
Total Amount is formed as General ($2,487) + Research ($0) + Ownership ($0) = $2,487.
Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Janssen Scientific Affairs, LLC ($628).
Total Amount
$2,487
General + Research + Ownership
Payments
77
Total payment records
General Amount
$2,487
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Janssen Scientific Affairs, LLC | $628 |
| ABBVIE INC. | $388 |
| Janssen Biotech, Inc. | $251 |
| Phathom Pharmaceuticals, Inc. | $199 |
| PFIZER INC. | $141 |
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: 2015-10-02
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 |
|---|---|---|---|---|
| I20151002001530 | I | Nurse Practitioner | ID | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 197 | 164 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 134 | 112 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 24 | 24 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 83814)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| NURSE PRACTITIONER | ID | 81002 | Urinalysis, manual test | 23 | 20 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Orthopedic Surgery | ID | |
| Physician Assistant | ID | |
| Surgical Oncology, Hematology/Oncology, General Surgery | WA | |
| Pulmonary Disease, Critical Care (Intensivists) | ID | |
| Physician Assistant | ID | |
| Undefined Non Physician Type (Specify) | ID | |
| Physician Assistant | UT | |
| Certified Nurse Midwife (Cnm) | ID | |
| Physician Assistant | ID | |
| Internal Medicine | TX |
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