NICOLE KATHLEEN GOVANNICCI (CRNP) – Family Nurse Practitioner, NPI 1891407409

NICOLE KATHLEEN GOVANNICCI (CRNP) is a healthcare provider. based in Broomall, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. SP026709 (PA). The NPI Number for NICOLE KATHLEEN GOVANNICCI (CRNP) is 1891407409

Main info

Female
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
NICOLE KATHLEEN GOVANNICCI (CRNP)
NPI
1891407409
Phone
(610) 787-2801
Address
2645 KIRK AVE
Enumeration Date
15 December 2022
Last Update Date
23 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2156461686
Graduation Year
2022 (4 years ago)
PAC ID
0042673253
Group Practice PAC ID
1850376211
Professional Enrollment ID
I20230905002987
Address ID
PA190341743FO1244XAVEX405
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:3State licenses:1Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

Provider Addresses for NICOLE KATHLEEN GOVANNICCI (CRNP)

  • 2645 KIRK AVE

    BROOMALL, PA 190081915

    Phone: (610) 787-2801

    Type: Mailing

  • 1244 FORT WASHINGTON AVE STE E2

    FORT WASHINGTON, PA 190341743

    Phone: (215) 646-1686

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 20 Open Payments records for all available years, with a total value of $380.

Total Amount is formed as General ($380) + Research ($0) + Ownership ($0) = $380.

Last reported payment date: 2024-10-31 • Largest payer in this snapshot: Novo Nordisk Inc ($83).

Total Amount

$380

General + Research + Ownership

Payments

20

Total payment records

General Amount

$380

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-31

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2023-09-05

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
I20230905002987INurse PractitionerPATBD

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
99213Established patient office or other outpatient visit, 20-29 minutes6057$0
99214Established patient office or other outpatient visit, 30-39 minutes1212$0
View full utilization report →

Insurance plans in this area (ZIP 19008)

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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: 1850376211View full group profile

Reviews

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Frequently asked questions

Does NICOLE KATHLEEN GOVANNICCI (CRNP) have a public NPI I can cite?
Public records show NICOLE KATHLEEN GOVANNICCI (CRNP) under NPI 1891407409.
Quick check: is NICOLE KATHLEEN GOVANNICCI (CRNP) active?
Public NPPES data shows NICOLE KATHLEEN GOVANNICCI (CRNP) with an active NPI status right now.
Which specialty label fits NICOLE KATHLEEN GOVANNICCI (CRNP)?
NPPES ties NICOLE KATHLEEN GOVANNICCI (CRNP) to Family Nurse Practitioner in the taxonomy section. Clinical services aligned with this taxonomy classification.
What geographic area is tied to NICOLE KATHLEEN GOVANNICCI (CRNP)?
NICOLE KATHLEEN GOVANNICCI (CRNP) is associated with Broomall, Pennsylvania in the same public data insurers reference.
Can I export NICOLE KATHLEEN GOVANNICCI (CRNP)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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