CAROLYN M. NICKEL (PA) – Physician Assistant, NPI 1558349910

CAROLYN M. NICKEL (PA) is a healthcare provider. based in Ypsilanti, Michigan. specializing in Physician Assistant. They hold the professional credentials PA. They hold a License No. 5601003972 (MI). The NPI Number for CAROLYN M. NICKEL (PA) is 1558349910

Main info

Female
24 Years Of Experience
Accepts Medicare Assignment
Name
CAROLYN M. NICKEL (PA)
NPI
1558349910
Phone
(734) 712-8676
Address
5301 E HURON RIVER DRIVE
Enumeration Date
5 January 2006
Last Update Date
24 January 2014

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7347123456
Graduation Year
2002 (24 years ago)
PAC ID
1557350642
Group Practice PAC ID
3779489281
Professional Enrollment ID
I20040512000845
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for CAROLYN M. NICKEL (PA)

  • 5301, East Huron River Drive, Superior Charter Township, Washtenaw County, Michigan, 48105, United States

    YPSILANTI, MI 48197

    Phone: (734) 712-8676

    Fax: (734) 712-3855

    Type: Location

  • PO BOX 446

    24 FRANK LLOYD WRIGHT DRIVE

    ANN ARBOR, MI 481060446

    Phone: (734) 747-6766

    Fax: (734) 220-3100

    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: 2004-05-12

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
I20040512000845IPhysician AssistantMITBD

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
99203New patient office or other outpatient visit, 30-44 minutes8989$0
99213Established patient office or other outpatient visit, 20-29 minutes2420$0
81003Automated urinalysis test1918$0
99204New patient office or other outpatient visit, 45-59 minutes1111$0
View full utilization report →

Insurance plans in this area (ZIP 48197)

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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: 3779489281View full group profile

Reviews

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Frequently asked questions

How do payers reference CAROLYN M. NICKEL (PA)?
For CAROLYN M. NICKEL (PA), use NPI 1558349910 as the unique 10-digit identifier.
Is CAROLYN M. NICKEL (PA) shown as active in public data?
Registry records indicate CAROLYN M. NICKEL (PA) maintains an active NPI.
What expertise is attributed to CAROLYN M. NICKEL (PA)?
CAROLYN M. NICKEL (PA)'s specialty line reads Physician Assistant. Clinical services aligned with this taxonomy classification.
What practice footprint exists for CAROLYN M. NICKEL (PA)?
Travel planning: use Ypsilanti, Michigan as the reference point for CAROLYN M. NICKEL (PA), then confirm.
Does CAROLYN M. NICKEL (PA) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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