Nicole D'Amico

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

28208148A Issued in IN

Practice address

10661 W la Porte Rd
Mokena, IL 60448-9475

Phone

(708) 925-3100

NPI assigned

Mar 11, 2021

Last updated

Feb 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Nicole Eberhardt Former name

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nwi Medical Associates , LLCGroup PAC ID 4183087257, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Hospital Hospital, Munster, IN, CCN 150125

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Nwi Medical Associates , LLC

  • Anesthesiology Physician
  • Munster, IN
  • NPI 1760182554

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• St Catherine Hospital Inc

  • General Acute Care Hospital
  • East Chicago, IN
  • NPI 1396847596
  Medicare reassignment NPD
• Munster Medical Research Foundation Inc

  • Anesthesiology Physician
  • Munster, IN
  • NPI 1982653044

  Nurse Anesthetist, Certified Registered

  NPD
• Munster Medical Research Foundation, Inc.

  dba Community Surgery Center Pharmacy

  • Community/Retail Pharmacy
  • Munster, IN
  • NPI 1235209826
  NPD
• St Catherine Hospital Inc

  • Anesthesiology Physician
  • East Chicago, IN
  • NPI 1649346537
  NPD
• St. Catherine Hospital Inc.

  dba St.Catherine Hospital Outpatient Pharmacy

  • Community/Retail Pharmacy
  • East Chicago, IN
  • NPI 1568806057
  NPD

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

• Munster Medical Research Foundation Inc

  dba Community Hospital

  • General Acute Care Hospital
  • Munster, IN
  • NPI 1003918210
  Care Compare affiliation

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

{
    "created_epoch": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1669057675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10661 W LA PORTE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489475",
            "telephone_number": "708-925-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10661 W LA PORTE RD",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489475",
            "telephone_number": "708-925-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "D'AMICO",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2022-02-23",
        "certification_date": "2022-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IN",
            "license": "28208148A",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041407135",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28208148A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "EBERHARDT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kylee L. Crowther, APN
• Lindsay Denise Currie
• Myhija Curry
• Brittany Cuthbert, M.S., CCC-SLP/L
• CVS Minute Clinic
• Danaher Family Medicine SC
• Michele A Danaher, MD
• Daniel & Max, LLC
• Lily Darche
• Brian Dauber, PT

• Certified Registered Nurse Anesthetist in Mokena, IL
• Providers in Mokena, IL by specialty
• Certified Registered Nurse Anesthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.