PETER MICK (NP-C) – Nurse Practitioner, NPI 1164074076

PETER MICK (NP-C) is a healthcare provider. based in Great bend, Kansas. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. 53-78864-062 (KS). The NPI Number for PETER MICK (NP-C) is 1164074076

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
PETER MICK (NP-C)
NPI
1164074076
Phone
(620) 285-1915
Address
1005 Williams St
Enumeration Date
10 July 2019
Last Update Date
9 September 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6207928833
Graduation Year
2019 (7 years ago)
PAC ID
8921433442
Group Practice PAC ID
5597016378
Professional Enrollment ID
I20200110000503
Address ID
KS675303562GR514XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness85
Years active:6State licenses:1Digital endpointsOther names

3,550 NURSE PRACTITIONER in KS

Provider Addresses for PETER MICK (NP-C)

  • 1005 Williams St

    Great Bend, KS 675304443

    Phone: (620) 285-1915

    Fax: (620) 269-6095

    Type: Location

  • Great Bend Regional Hospital, 514, Cleveland Street, Great Bend, Barton County, Kansas, 67530, United States

    GREAT BEND, KS 675303562

    Phone:

    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 $14.

Total Amount is formed as General ($14) + Research ($0) + Ownership ($0) = $14.

Last reported payment date: 2023-03-29 • Largest payer in this snapshot: PFIZER INC. ($14).

Total Amount

$14

General + Research + Ownership

Payments

1

Total payment records

General Amount

$14

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2023-03-29

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
PFIZER INC.$14
View all Open Payments →|Open Payments Risk Radar →

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: 2020-01-10

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20200110000503INurse PractitionerKSTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making213201$0
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only177159$0
99284Emergency department visit with moderate level of medical decision making7270$0
99283Emergency department visit with low level of medical decision making1918$0
View full utilization report →

Insurance plans in this area (ZIP 67530)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5597016378View full group profile
NameSpecialtyState
Family PracticeKS
Physician AssistantKS
-TN
O B S T E T R I C S/ G Y N E C O L O G YKS
Nurse PractitionerKS
Nurse PractitionerKS
Physical Therapist In Private PracticeKS
-MS
Emergency Medicine, Family PracticeKS
Nurse PractitionerKS

Reviews

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Frequently asked questions

How is PETER MICK (NP-C) identified in CMS data?
CMS-hosted NPPES data lists PETER MICK (NP-C) with NPI 1164074076.
Is PETER MICK (NP-C) listed as active for patients and plans?
The listing shows PETER MICK (NP-C) as active in the NPI system.
What taxonomy line describes PETER MICK (NP-C)?
For research purposes, treat PETER MICK (NP-C) as Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where should I expect PETER MICK (NP-C) on a map?
Expect Great Bend, Kansas as a primary anchor for PETER MICK (NP-C) unless the record lists multiple sites.
Why does PETER MICK (NP-C) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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