NICOLE RENEE NISSEN – Family Nurse Practitioner, NPI 1629569843
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
Provider Addresses for NICOLE RENEE NISSEN
10426 BAUR BLVD
SAINT LOUIS, MO 631321905
Phone: (314) 925-0903
Type: Mailing
623 HAMACHER ST
WATERLOO, IL 622981786
Phone: (314) 925-0903
Type: Location
121 SAINT LUKES CENTER DR STE 403
CHESTERFIELD, MO 630173519
Phone: (314) 205-6149
Type: Location
210, Northeast Tudor Road, AMLI Summit Ridge, Lee's Summit, Jackson County, Missouri, 64086, United States
LEES SUMMIT, MO 640865696
Phone: (888) 256-3814
Fax: (888) 256-9054
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: 2018-09-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20180827001542 | I | Nurse Practitioner | MO | TBD |
| I20180910002278 | I | Nurse Practitioner | IL | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99309 | Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes | 1,222 | 147 | $0 |
| 99310 | Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes | 296 | 82 | $0 |
| 99308 | Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes | 36 | 19 | $0 |
| 99316 | Nursing facility discharge management, more than 30 minutes | 11 | 11 | $0 |
Insurance plans in this area (ZIP 63132)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Family Practice, Hospitalist | MO | |
| Internal Medicine | IL | |
| Internal Medicine | MI | |
| Nurse Practitioner | IL | |
| Hospitalist, Internal Medicine | MO | |
| Internal Medicine | MO |
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