Ms Nicole Denise Nickens, MSN, A-GPNP-BC, - Medicare Nurse Practitioner in Willoughby, OH

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Ms Nicole Denise Nickens, MSN, A-GPNP-BC, is a medicare enrolled "Nurse Practitioner" in Willoughby, Ohio. Her current practice location is 30841 Euclid Ave Ste 103, Willoughby, Ohio. You can reach out to her office (for appointments etc.) via phone at (216) 441-2496.

Ms Nicole Denise Nickens is licensed to practice in Ohio (license number APRN.CNP.020745) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1609082486.

Contact Information

Ms Nicole Denise Nickens, MSN, A-GPNP-BC,
30841 Euclid Ave Ste 103,
Willoughby, OH 44094-3100
(216) 441-2496
(216) 453-5966

Map and Direction




Provider's Profile

Full NameMs Nicole Denise Nickens
GenderFemale
SpecialityNurse Practitioner
Location30841 Euclid Ave Ste 103, Willoughby, Ohio
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1609082486
  • Provider Enumeration Date: 05/16/2007
  • Last Update Date: 06/23/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0446537484
  • Enrollment ID: I20170501001418

Medical Identifiers

Medical identifiers for Ms Nicole Denise Nickens such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1609082486NPI-NPPES
0223866MedicaidOH
1609082486MedicaidOH
0323866MedicaidOH
2462777MedicaidOH

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse RN346914 (Ohio)Secondary
207RA0401XInternal Medicine - Addiction Medicine CNP020745 (Ohio)Secondary
363L00000XNurse Practitioner APRN.CNP.020745 (Ohio)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Nicole Denise Nickens allows following entities to bill medicare on her behalf.
Entity NameRakesh Ranjan M.d. & Assoc., Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1033143722
PECOS PAC ID: 6507895067
Enrollment ID: O20050805000212
Entity NameJordan Community Residential Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1164068524
PECOS PAC ID: 6305210220
Enrollment ID: O20230316000356

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Nicole Denise Nickens is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Ms Nicole Denise Nickens, MSN, A-GPNP-BC,
30841 Euclid Ave Ste 103,
Willoughby, OH 44094-3100

Ph: (216) 441-2496		Ms Nicole Denise Nickens, MSN, A-GPNP-BC,
30841 Euclid Ave Ste 103,
Willoughby, OH 44094-3100

Ph: (216) 441-2496

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.