Individual provider Active NPI

Nicole Banasik, MSN, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Cedar Rapids, IA
National Provider Identifier
1609521202
Registry record updated Jan 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
H166907 Issued in IA
Practice address
701 10TH St SE
Cedar Rapids, IA 52403-1292
Phone
(319) 398-6011
NPI assigned
Feb 14, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2100X H166907 IA Primary

Addresses

Primary practice location

701 10TH St SE
Cedar Rapids, IA 52403-1292

Mailing address

788 8TH Ave SE Ste 200
Cedar Rapids, IA 52401-2106
Phone (847) 997-4274

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20220323000093 IA Practitioner - Nurse Practitioner 3173918406 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Medical CenterGroup PAC ID 4183535271, 295 clinicians

Practice addresses (Care Compare)

701 10TH St SE
Cedar Rapids, IA 52403-1251

701 10TH St SE
Cedar Rapids, IA 52403-1292

701 10TH St SE J Edward Lundy
Mercy Pediatric Clinic
Cedar Rapids, IA 52403-1251
Phone (319) 832-2328

788 8TH Ave SE
Cedar Rapids, IA 52401-2106

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
H166907IAMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Medical Center Multi-Specialty CurrentSince Mar 1, 2022 Accepting new patients
Mercy Medical Center CurrentSince Mar 1, 2022 Accepting new patients
Mercy Medical Center Multi-Specialty Current Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

788 8th Ave SE
Ste 200
Cedar Rapids, IA 52401
Phone (319) 221-8788

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 and National Provider Directory roles.

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": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673222400000",
    "number": "1609521202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "788 8TH AVE SE STE 200",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524012106",
            "telephone_number": "847-997-4274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 10TH ST SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524031292",
            "telephone_number": "319-398-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANASIK",
        "first_name": "NICOLE",
        "credential": "MSN, AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-14",
        "last_updated": "2023-01-09",
        "certification_date": "2023-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IA",
            "license": "H166907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.