DR. NICOLE MARIE ALCORN (ARNP) – Pediatric Nurse Practitioner, NPI 1124796172

DR. NICOLE MARIE ALCORN (ARNP) is a healthcare provider. based in Minneapolis, Minnesota. specializing in NURSE PRACTITIONER. They hold the professional credentials ARNP. They hold a License No. 8487 (MN). The NPI Number for DR. NICOLE MARIE ALCORN (ARNP) is 1124796172

Main info

Female
7 Years Of Experience
Name
DR. NICOLE MARIE ALCORN (ARNP)
NPI
1124796172
Phone
Not provided
Address
2525 CHICAGO AVE
Enumeration Date
3 September 2021
Last Update Date
3 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6128136273
Graduation Year
2019 (7 years ago)
PAC ID
0042600389
Group Practice PAC ID
2668370966
Professional Enrollment ID
I20211201000705
Address ID
MN554044518MI2525XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

5,720 NURSE PRACTITIONER in MN

Provider Addresses for DR. NICOLE MARIE ALCORN (ARNP)

  • 2525 CHICAGO AVE

    MINNEAPOLIS, MN 554044518

    Phone:

    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: 2021-12-01

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
I20211201000705INurse PractitionerMNTBD

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 55404)

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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: 2668370966View full group profile
NameSpecialtyState
-MN
Pediatric MedicineMN
Diagnostic RadiologyMN
Nurse PractitionerMN
H E M A T O L O G Y/ O N C O L O G YMN
Nuclear Medicine, Pediatric Medicine, Diagnostic RadiologyKY
-MN
-MN
H E M A T O L O G Y/ O N C O L O G YMN
Nurse PractitionerMN

Reviews

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Frequently asked questions

What number should I use to identify DR. NICOLE MARIE ALCORN (ARNP) for billing?
Administrative and clinical systems typically use NPI 1124796172 for DR. NICOLE MARIE ALCORN (ARNP).
Is DR. NICOLE MARIE ALCORN (ARNP) currently accepting referrals based on NPI status?
Registry metadata lists DR. NICOLE MARIE ALCORN (ARNP) as active.
How should patients interpret DR. NICOLE MARIE ALCORN (ARNP)'s specialty?
The extract shows Pediatric Nurse Practitioner for DR. NICOLE MARIE ALCORN (ARNP). Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. NICOLE MARIE ALCORN (ARNP)?
DR. NICOLE MARIE ALCORN (ARNP) is associated with Minneapolis, Minnesota in the same public data insurers reference.
Who maintains DR. NICOLE MARIE ALCORN (ARNP)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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