MRS. NICOLE JEAN HENNICKE (CRNA) – Certified Registered Nurse Anesthetist, NPI 1396040432

MRS. NICOLE JEAN HENNICKE (CRNA) is a healthcare provider. based in Cleveland, Ohio. specializing in CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA). They hold the professional credentials CRNA. They hold a License No. RN.323311 (OH). The NPI Number for MRS. NICOLE JEAN HENNICKE (CRNA) is 1396040432

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
MRS. NICOLE JEAN HENNICKE (CRNA)
NPI
1396040432
Phone
(216) 844-7334
Address
11100 EUCLID AVE
Enumeration Date
21 January 2011
Last Update Date
24 August 2012

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2005 (21 years ago)
PAC ID
4981884830
Group Practice PAC ID
1850203555
Professional Enrollment ID
I20110209000528
Address ID
OH441950001CL9500XAVEX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience44
Completeness75
Years active:15State licenses:1Digital endpointsOther names

3,016 CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA) in OH

Provider Addresses for MRS. NICOLE JEAN HENNICKE (CRNA)

  • 11100 EUCLID AVE

    CLEVELAND, OH 44106

    Phone: (216) 844-7334

    Type: Location

  • 24700 EUCLID AVE

    EUCLID, OH 44117

    Phone: (216) 383-6614

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $31.

Total Amount is formed as General ($31) + Research ($0) + Ownership ($0) = $31.

Last reported payment date: 2024-07-22 • Largest payer in this snapshot: Merck Sharp & Dohme LLC ($31).

Total Amount

$31

General + Research + Ownership

Payments

2

Total payment records

General Amount

$31

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-22

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Merck Sharp & Dohme LLC$31
View all Open Payments →|Open Payments Risk Radar →

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: 2011-02-09

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
I20110209000528ICertified Registered Nurse Anesthetist (Crna)OHTBD

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
00320Anesthesia for other procedure on neck area (1 year or older)4444$0
View full utilization report →

Insurance plans in this area (ZIP 44106)

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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: 1850203555View full group profile
NameSpecialtyState
-NV
Nephrology, Internal MedicineOH
-OH
-MI
Nurse PractitionerOH
General Surgery, Anesthesiology, Critical Care (Intensivists)OH
Family PracticeOH
Certified Registered Nurse Anesthetist (Crna)OH
-OH
-MN

Reviews

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Frequently asked questions

How do payers reference MRS. NICOLE JEAN HENNICKE (CRNA)?
For MRS. NICOLE JEAN HENNICKE (CRNA), use NPI 1396040432 as the unique 10-digit identifier.
Is MRS. NICOLE JEAN HENNICKE (CRNA) still an active registrant?
MRS. NICOLE JEAN HENNICKE (CRNA) carries an active NPI according to the public dataset.
What clinical focus is listed for MRS. NICOLE JEAN HENNICKE (CRNA)?
At a glance, MRS. NICOLE JEAN HENNICKE (CRNA) is tied to Certified Registered Nurse Anesthetist. Clinical services aligned with this taxonomy classification.
What locale is associated with MRS. NICOLE JEAN HENNICKE (CRNA)?
Directory geography for MRS. NICOLE JEAN HENNICKE (CRNA) centers on Cleveland, Ohio.
Can I trust this NPI listing for MRS. NICOLE JEAN HENNICKE (CRNA)?
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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