Nicklas Lee Raycraft, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704318829 Issued in MI

Practice address

1500 E Sherman Blvd
Muskegon, MI 49444-1849

Phone

(231) 728-4601

NPI assigned

Aug 24, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Saginaw Valley Medical College - NLG, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Interlochen Emergency Group PCGroup PAC ID 3577918606, 49 clinicians

Caberfae Emergency Group PCGroup PAC ID 4082069232, 39 clinicians

Lake Michigan Emergency Specialists, PLLCGroup PAC ID 0749569242, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Paul Oliver Memorial Hospital Hospital, Frankfort, MI, CCN 231300

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Interlochen Emergency Group, P.C.

  • Emergency Medicine Physician
  • Traverse City, MI
  • NPI 1336821495
  Medicare reassignment Care Compare group NPD
• Lake Michigan Emergency Specialists, PLLC

  • Emergency Medicine Physician
  • Muskegon, MI
  • NPI 1124574520
  Medicare reassignment Care Compare group NPD
• Caberfae Emergency Group, P.C.

  • Emergency Medicine Physician
  • Cadillac, MI
  • NPI 1447932504
  Medicare reassignment Care Compare group
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Critical Access Hospital
  • Ironwood, MI
  • NPI 1649297342
  Medicare reassignment NPD
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Family Medicine Physician
  • Ironwood, MI
  • NPI 1992704753
  Medicare reassignment NPD
• Epi PC

  • Emergency Medicine Physician
  • Holland, MI
  • NPI 1225082266
  Medicare reassignment NPD
• Lake Michigan Observation Services PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Muskegon, MI
  • NPI 1518626043
  Medicare reassignment NPD
• Hawk Emergency Group, P.C.

  • Emergency Medicine Physician
  • Charlevoix, MI
  • NPI 1073295135
  Medicare reassignment
• Aspirus Ironwood Hospital & Clinics, Inc.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Ironwood, MI
  • NPI 1609743590
  NPD

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

• Paul Oliver Memorial Hospital

  • Critical Access Hospital
  • Frankfort, MI
  • NPI 1427054360
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1154934842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "671 WHITMAN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494236742",
            "telephone_number": "810-588-7066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494441849",
            "telephone_number": "231-728-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYCRAFT",
        "first_name": "NICKLAS",
        "middle_name": "LEE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704318829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lady Yohanna Rau, FNP
• David James Rawlinson, D.O.
• Amanda P Rawson, DO
• A'Yonna Ray, RN
• Anika Symone' Ray
• Julie Raynor, SLP
• Connie J Reahm, RN
• Denise Rebedew, HHA
• Jeffrey D Recknagel, M.D.
• Joshua Robert Recknagel, MD

• Family Nurse Practitioner in Muskegon, MI
• Providers in Muskegon, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.