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Individual provider Active NPI

Nicole Ann Krosnicki, NURSE PRACTITIONER

  • Family Nurse Practitioner
  • Sandusky, MI
National Provider Identifier
1134539265
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704257242 Issued in MI
Practice address
170 W Argyle St
Sandusky, MI 48471-1097
Phone
(810) 648-3229
NPI assigned
Apr 29, 2014
Sex
Female
Sole proprietor
No

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McKenzie Memorial Hospital 31 clinicians
Sciometrix LLC 58 clinicians

Practice addresses (Care Compare)

100 Argyle St
Suite 3
Sandusky, MI 48471
Phone (810) 648-6162

120 Delaware St
Sandusky, MI 48471

306 S Washington Ave
Suite 600
Royal Oak, MI 48067-3837
Phone (860) 335-5064

Hospital & facility affiliations

  • Residential Home Health and Hospice Home health agency, Lapeer, MI, CCN 237495
  • McKenzie Health System Hospital, Sandusky, MI, CCN 231314
  • Marlette Regional Hospital Hospital, Marlette, MI, CCN 231330
  • Deckerville Community Hospital Hospital, Deckerville, MI, CCN 231311

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140618002424 MI Practitioner - Nurse Practitioner 7911121645 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704257242MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie Memorial Hospital Current Accepting new patients
Sciometrix LLC CurrentSince Nov 1, 2024 Accepting new patients
Sciometrix Inc CurrentSince Nov 1, 2024 Accepting new patients
McKenzie Memorial Hospital Past Accepting new patients

Locations

8 N Howard Ave
Croswell, MI 48422
Phone (810) 679-0012

306 S Washington Ave
Ste 600
Royal Oak, MI 48067

120 N Delaware St
Sandusky, MI 48471
Phone (810) 648-3770

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704257242 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

170 W Argyle St
Sandusky, MI 48471-1097

Mailing address

120 N Delaware St
Sandusky, MI 48471-1009
Phone (810) 648-3770

Other names 1

NPPES NPI Registry
  • Nicole Ann Liccardello Former name

Electronic endpoints 1

NPPES NPI Registry
TypeEndpointUseAffiliation
Direct Messaging Address nicole.demarco@mhs.eclinicaldirectplus.com

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 24, 2022.

{
    "created_epoch": "1398729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1134539265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N DELAWARE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711009",
            "telephone_number": "810-648-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W ARGYLE ST",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711097",
            "telephone_number": "810-648-3229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROSNICKI",
        "first_name": "NICOLE",
        "middle_name": "ANN",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-29",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704257242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicole.demarco@mhs.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "170 W Argyle St",
            "city": "Sandusky",
            "state": "MI",
            "country_code": "US",
            "postal_code": "484711097",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "LICCARDELLO",
            "middle_name": "ANN",
            "credential": "NP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sandusky, MI

Sources for this page

Verify at the official NPI Registry.