Carmen Kosicek, PMHNP – Psychiatric/Mental Health Nurse Practitioner, NPI 1952860066
Psychiatric/Mental Health Nurse Practitioner
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Carmen Kosicek, PMHNP
395 SW Bluff Dr Ste 10
Bend, OR 977021670
Phone: (503) 755-6703
Fax: (503) 755-6704
Type: Location
1314B CENTER DR UNIT 439
MEDFORD, OR 975017943
Phone: (262) 260-9000
Fax: (262) 260-9109
Type: Location
PO BOX 2178
WILSONVILLE, OR 970702178
Phone: (503) 678-5626
Fax: (503) 678-2223
Type: Mailing
1846 E INNOVATION PARK DR
ORO VALLEY, AZ 857551963
Phone: (503) 755-6703
Fax: (503) 755-6704
Type: Mailing
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)
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: 2020-09-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Revalidation due soon
Earliest CMS due date is 2026-08-31 (83 days away).
Enrollment records
1
Earliest due date
2026-08-31
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 |
|---|---|---|---|---|
| O20200918000789 | O | Clinic/Group Practice | OR | 2026-08-31 |
What to do next
- Confirm the due date on the CMS Revalidation Lookup Tool.
- Complete revalidation in PECOS before the published due date.
- If you have multiple enrollment records, revalidate each one on its own schedule.
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 97702)
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