JEREMY MICHAEL NICOSKI – Certified Registered Nurse Anesthetist, NPI 1336786078

JEREMY MICHAEL NICOSKI is a healthcare provider. based in Hancock, Michigan. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold a License No. 4704334699 (MI). The NPI Number for JEREMY MICHAEL NICOSKI is 1336786078

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
JEREMY MICHAEL NICOSKI
NPI
1336786078
Phone
(906) 483-1516
Address
500 CAMPUS DR
Enumeration Date
2 December 2019
Last Update Date
2 December 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9063373100
Graduation Year
2019 (7 years ago)
PAC ID
0345677985
Group Practice PAC ID
8123912011
Professional Enrollment ID
I20200220003068
Address ID
MI499132134LA205XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:6State licenses:1Digital endpointsOther names

2,692 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in MI

Provider Addresses for JEREMY MICHAEL NICOSKI

  • 500 CAMPUS DR

    HANCOCK, MI 499301452

    Phone: (906) 483-1516

    Type: Location

  • 1922 WHIPPOORWILL WAY

    SARTELL, MN 563774706

    Phone: (320) 493-1477

    Type: Mailing

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: 2020-02-20

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
I20200220003068ICertified Registered Nurse Anesthetist (Crna)MITBD

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 49930)

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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: 8123912011View full group profile
NameSpecialtyState
-MI
Orthopedic SurgeryMI
-MI
-MI
Family PracticeMI
Diagnostic RadiologyMI
Family PracticeMI
-MI
Internal Medicine, Pulmonary DiseaseVA
D E R M A T O L O G YMI

Reviews

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Frequently asked questions

What is JEREMY MICHAEL NICOSKI's NPI number?
JEREMY MICHAEL NICOSKI's NPI is 1336786078 — the number used across U.S. healthcare to identify this provider.
Active or inactive — what applies to JEREMY MICHAEL NICOSKI?
You should see JEREMY MICHAEL NICOSKI as active in CMS-hosted NPPES data.
What expertise is attributed to JEREMY MICHAEL NICOSKI?
JEREMY MICHAEL NICOSKI's specialty line reads Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
Where in Michigan is JEREMY MICHAEL NICOSKI registered?
Use Hancock, Michigan as the headline location for JEREMY MICHAEL NICOSKI here.
Can I trust this NPI listing for JEREMY MICHAEL NICOSKI?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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