Individual provider Active NPI

Devyn Brittany Nickerson, CRNA

  • Certified Registered Nurse Anesthetist
  • Wexford, PA
National Provider Identifier
1265240592
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN709595 Issued in PA
Practice address
12351 Perry Hwy
Wexford, PA 15090-8344
Phone
(724) 939-3673
NPI assigned
Dec 19, 2024
Last updated
Jan 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN709595 PA Primary
Certified Registered Nurse Anesthetist 367500000X 153128 PA

Addresses

Primary practice location

12351 Perry Hwy
Wexford, PA 15090-8344

Mailing address

154 Walnut Dr
Baden, PA 15005-2356
Phone (304) 312-5793

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250103000968 PA Practitioner - Certified Registered Nurse Anesthetist (Crna) 6305374398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allegheny ClinicGroup PAC ID 5395649586, 2,313 clinicians

Practice addresses (Care Compare)

12351 Perry Hwy
Wexford, PA 15090-8344
Phone (412) 359-6581

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
153128PAMDCertified Registered Nurse Anesthetist
RN709595PAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Allegheny Clinic CurrentSince Jan 2, 2025 Accepting new patients
Allegheny Clinic Current Accepting new patients
Allegheny Clinic CurrentSince Jan 2, 2025 Accepting new patients

Locations

1301 Carlisle St
Natrona Hts, PA 15065
Phone (724) 224-5100

320 E North Ave
Pittsburgh, PA 15212
Phone (412) 359-3131

12311 Perry Hwy
Wexford, PA 15090
Phone (878) 332-4143

12351 Perry Hwy
Wexford, PA 15090
Phone (412) 359-3030

Organizations & group practices 3

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1734566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1265240592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 WALNUT DR",
            "city": "BADEN",
            "state": "PA",
            "postal_code": "150052356",
            "telephone_number": "304-312-5793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12351 PERRY HWY",
            "city": "WEXFORD",
            "state": "PA",
            "postal_code": "150908344",
            "telephone_number": "724-939-3673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "DEVYN",
        "middle_name": "BRITTANY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-19",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "RN709595",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "PA",
            "license": "153128",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wexford, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.