CARMEN KOSICEK (PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1255863767
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
3,379 NURSE PRACTITIONER in OR
Provider Addresses for CARMEN KOSICEK (PMHNP-BC)
1001, Cecelia Drive, Village of Pewaukee, Waukesha County, Wisconsin, 53072, United States
SUITE 200
PEWAUKEE, WI 530722546
Phone:
Type: Mailing
11740 SW 68th Pkwy Ste 200
Portland, OR 972239058
Phone: (425) 477-4216
Type: Location
395 SW Bluff Dr Ste 10
Bend, OR 977021670
Phone: (503) 755-6703
Fax: (503) 755-6704
Type: Location
1846 E INNOVATION PARK DR
ORO VALLEY, AZ 857551963
Phone: (520) 771-0555
Fax: (262) 260-9109
Type: Location
535 SE WASHINGTON ST
HILLSBORO, OR 971234142
Phone: (503) 755-6703
Fax: (503) 755-6704
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 277 Open Payments records for all available years, with a total value of $59,263.
Total Amount is formed as General ($59,263) + Research ($0) + Ownership ($0) = $59,263.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Teva Pharmaceuticals USA, Inc. ($38,386).
Total Amount
$59,263
General + Research + Ownership
Payments
277
Total payment records
General Amount
$59,263
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Teva Pharmaceuticals USA, Inc. | $38,386 |
| ITI, Inc. | $13,182 |
| USWM, LLC | $1,676 |
| ABBVIE INC. | $1,586 |
| Corium, LLC | $950 |
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: 2020-09-18
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20200918000878 | I | Nurse Practitioner | OR | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 53072)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | OR | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | OR | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | WI | |
| Nurse Practitioner | SC | |
| Nurse Practitioner | OR |
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