LISA M NICHOLS (FNP) – Family Nurse Practitioner, NPI 1063872109
Family Nurse Practitioner
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Profile Insights
NPPES metrics only — not quality of care.
8,192 NURSE PRACTITIONER in IN
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Provider Addresses for LISA M NICHOLS (FNP)
407, West Indiana Avenue, Morgan Park, Chesterton, Porter County, Indiana, 46304, United States
CHESTERTON, IN 463042350
Phone: (219) 763-8112
Fax: (219) 764-5380
Type: Location
Portage, Box Elder County, Utah, 84331, United States
PORTAGE, IN 463689230
Phone: (219) 763-8112
Fax: (219) 764-5384
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 33 Open Payments records for all available years, with a total value of $619.
Total Amount is formed as General ($619) + Research ($0) + Ownership ($0) = $619.
Last reported payment date: 2024-10-29 • Largest payer in this snapshot: ABBVIE INC. ($141).
Total Amount
$619
General + Research + Ownership
Payments
33
Total payment records
General Amount
$619
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-29
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $141 |
| Lundbeck LLC | $97 |
| Teva Pharmaceuticals USA, Inc. | $77 |
| BioXcel Therapeutics, Inc. | $37 |
| Corium, LLC | $36 |
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: 2020-03-26
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 |
|---|---|---|---|---|
| I20200326000496 | I | Nurse Practitioner | IN | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 96 | 40 | $0 |
| 90792 | Psychiatric diagnostic evaluation with medical services | 19 | 19 | $0 |
Insurance plans in this area (ZIP 46304)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | IN | |
| Mental Health Counselor | IN | |
| Clinical Psychologist | IL | |
| Mental Health Counselor | IL | |
| Mental Health Counselor | IN | |
| P S Y C H I A T R Y | MD | |
| Nurse Practitioner | IN | |
| Nurse Practitioner | IN | |
| Clinical Social Worker | IN | |
| Clinical Social Worker | IN |
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