Nicole Renee Nissen, - Medicare Nurse Practitioner in Waterloo, IL

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Nicole Renee Nissen, is a medicare enrolled "Nurse Practitioner - Family" in Waterloo, Illinois. She graduated from nursing school in 2017 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Generation Clinical Partners Llc, Pai Participant 27, Pc, Cep America - Illinois Snf Llp and her current practice location is 623 Hamacher St, Waterloo, Illinois. You can reach out to her office (for appointments etc.) via phone at (314) 925-0903.

Nicole Renee Nissen is licensed to practice in Missouri (license number 2018012260) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1629569843.

Contact Information

Nicole Renee Nissen,
623 Hamacher St,
Waterloo, IL 62298-1786
(314) 925-0903
Not Available

Map and Direction




Provider's Profile

Full NameNicole Renee Nissen
GenderFemale
SpecialityNurse Practitioner
Experience8 Years
Location623 Hamacher St, Waterloo, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Nicole Renee Nissen graduated from nursing school in 2017
  NPI Data:
  • NPI Number: 1629569843
  • Provider Enumeration Date: 05/23/2018
  • Last Update Date: 04/17/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 0547519423
  • Enrollment ID: I20180910002278

Medical Identifiers

Medical identifiers for Nicole Renee Nissen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1629569843NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner 209017442 (Illinois)Secondary
363LF0000XNurse Practitioner - Family 2018012260 (Missouri)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Generation Clinical Partners Llc155768780321
Pai Participant 27, Pc26688726724
Cep America - Illinois Snf Llp80223067378

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. Nicole Renee Nissen allows following entities to bill medicare on her behalf.
Entity NameCep America - Illinois Snf Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073069415
PECOS PAC ID: 8022306737
Enrollment ID: O20161012002933
Entity NameGeneration Clinical Partners Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1366050007
PECOS PAC ID: 1557687803
Enrollment ID: O20200908001358
Entity NamePai Participant 27, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093398539
PECOS PAC ID: 2668872672
Enrollment ID: O20210614001032

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. Nicole Renee Nissen 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
Nicole Renee Nissen,
10426 Baur Blvd,
Saint Louis, MO 63132-1905

Ph: (314) 925-0903		Nicole Renee Nissen,
623 Hamacher St,
Waterloo, IL 62298-1786

Ph: (314) 925-0903

Reviews and Comments


Nurse Practitioner Nurses in Waterloo, IL

Mr. Matthew Robert Jones, ACNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 509 Hamacher St Ste 202, Waterloo, IL 62298
Phone: 618-939-4200    Fax: 618-939-4256
Courtney Mccarty, CPNP-PC
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 224 Bradford Ln, Waterloo, IL 62298
Phone: 618-939-0112    Fax: 618-939-0119
Ms. Carol Ann Glascock, APNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 723 Station Xing, Waterloo, IL 62298
Phone: 618-939-1551    Fax: 618-939-1553
Megan Roberts,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 224 Bradford Ln, Waterloo, IL 62298
Phone: 618-939-0112    
Shanna Witges, APRN NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 509 Hamacher St Ste 102, Waterloo, IL 62298
Phone: 618-939-3939    
Dr. Megan Lutman, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 921 Kimberly Ln, Waterloo, IL 62298
Phone: 314-456-6008    
Marla Rae Smith,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 869 North Illinois Rt 3, Waterloo, IL 62298
Phone: 618-939-7771    Fax: 618-939-7746

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.