NPIMap

Individual provider Active NPI

Nicole Lynn McCune

  • Certified Registered Nurse Anesthetist
  • Anchorage, AK
National Provider Identifier
1164893269
Registry record updated Oct 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1042969 Issued in AK
Practice address
4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone
(907) 729-3973
NPI assigned
Oct 14, 2015
Last updated
Oct 14, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1042969 AK Primary

Addresses

Primary practice location

4315 Diplomacy Dr
Anchorage, AK 99508-5926

Mailing address

889 W Chena Hills Dr
Fairbanks, AK 99709-5716
Phone (330) 357-1795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, AK2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151130000981 TX Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880994631 Reassigns benefits to 1 organization
I20240826004226 AK Practitioner - Certified Registered Nurse Anesthetist (Crna) 4880994631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4315 Diplomacy Dr
Anchorage, AK 99508-5926
Phone (907) 563-2662

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1042969AKMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Native Tribal Health Consortium CurrentSince Oct 19, 2015 Accepting new patients
Ketamine Wellness Institute, LLC CurrentSince Aug 1, 2024 Accepting new patients

Locations

4050 Lake Otis Pkwy
Ste 208
Anchorage, AK 99508
Phone (907) 317-1331

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

Interoperability endpoints

  • Direct secure messaging: nmccune@direct.anthc.org

Organizations & group practices 2

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

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444780800000",
    "number": "1164893269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "889 W CHENA HILLS DR",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997095716",
            "telephone_number": "330-357-1795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4315 DIPLOMACY DR",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995085926",
            "telephone_number": "907-729-3973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCUNE",
        "first_name": "NICOLE",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-14",
        "last_updated": "2015-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AK",
            "license": "1042969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.