NICOLE MEDARIS (LPC) – Professional Counselor, NPI 1487110722

NICOLE MEDARIS (LPC) is a healthcare provider. based in Manhattan, Kansas. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 3352 (KS). The NPI Number for NICOLE MEDARIS (LPC) is 1487110722

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE MEDARIS (LPC)
NPI
1487110722
Phone
(785) 776-4105
Address
1408 POYNTZ AVE
Enumeration Date
12 February 2019
Last Update Date
12 February 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7857764105
Graduation Year
2017 (9 years ago)
PAC ID
5092168831
Group Practice PAC ID
0547484917
Professional Enrollment ID
I20240129003195
Address ID
KS665024145MA1408XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:7State licenses:1Digital endpointsOther names

387 MENTAL HEALTH COUNSELOR in KS

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Provider Addresses for NICOLE MEDARIS (LPC)

  • 1408, Poyntz Avenue, Manhattan, Riley County, Kansas, 66502, United States

    MANHATTAN, KS 665024145

    Phone: (785) 776-4105

    Fax: (785) 537-2299

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2024-01-29

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
I20240129003195IMental Health CounselorKSTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66502)

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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: 0547484917View full group profile
NameSpecialtyState
Clinical Social WorkerKS
Marriage And Family TherapistKS
Clinical Social WorkerKS
Marriage And Family TherapistKS
-KS
Clinical PsychologistIN
Marriage And Family TherapistKS
Mental Health CounselorKS

Reviews

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Frequently asked questions

What is the 10-digit NPI for NICOLE MEDARIS (LPC)?
NICOLE MEDARIS (LPC) — NPI 1487110722 — is the standard way to identify this listing.
Does CMS list NICOLE MEDARIS (LPC) as active?
Yes — NICOLE MEDARIS (LPC) is active in the NPI listing used on this page.
What healthcare role does NICOLE MEDARIS (LPC) hold?
Scheduling teams often label NICOLE MEDARIS (LPC) under Professional Counselor. Clinical services aligned with this taxonomy classification.
Does NICOLE MEDARIS (LPC) list a practice location?
Patients near Manhattan, Kansas may find NICOLE MEDARIS (LPC) in results; validate coverage separately.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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