NICOLE RENEE DAVIS-MARENCO FNP
NPI 1114788767
Nurse Practitioner in Modesto, CA

Q: What is Nicole Davis-marenco's NPI number?

The NPI number for Nicole Davis-marenco is 1114788767. It was assigned to this individual provider in the NPPES registry on January 22, 2024. The provider is also known as Nicole Renee Davis.

Q: What is Nicole Davis-marenco's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since January 22, 2024PECOS Enrolled

4125 BANGS AVE, MODESTO, CA 95356(209) 735-5510 Get Directions Write a Review

NPPES record last updated: January 16, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jan 16, 2026, Dec 24, 2024 (2 updates tracked since 2024).

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About Nicole Renee Davis-marenco Fnp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE RENEE DAVIS-MARENCO FNP (NPI 1114788767) is an individual nurse practitioner in Modesto, California, licensed in California (95028700) and active in the NPI registry since January 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114788767

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameNICOLE RENEE DAVIS-MARENCOCredential: FNP

Location Address4125 BANGS AVEModesto, CA 95356-8713

Mailing Address4125 Bangs AveModesto, CA 95356-8713 · (209) 735-5510

Phone(209) 735-5510

Sole ProprietorNo

Enumeration DateJanuary 22, 2024

Last NPPES UpdateJanuary 16, 20262 updates tracked since enumeration

NPPES CertifiedJanuary 16, 2026

✔ NPI 1114788767 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in CA · 95028700

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

4125 BANGS AVE, Modesto, CA 95356

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Other Names 1

Former Name (1)Nicole Renee Davis

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Renee Davis-marenco Fnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Nicole Davis-marenco reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Leslie A. Storey, M.D., Inc.

91 mi

MOHS-Micrographic Surgery

7777 N. INGRAM AVE.
Fresno, CA 93711

Reassigned Medicare billing, California enrollment
Medicare enrollment name: Leslie A Storey MD Inc
2 clinicians in this Medicare group

NPI 1871023432 (559) 472-7546

Sharp Rees-Stealy Medical Group, Inc

401 mi

Internal Medicine

5651 COPLEY DR STE A
San Diego, CA 92111

Reassigned Medicare billing, California enrollment
1,233 clinicians in this Medicare group

NPI 1285616177 (858) 262-6666

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

42 services40 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95356 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$90.32 typical visit price

range $58.87 – $176.60

Typical copayment $22.58 (range $14.71 – $44.15)

Most-billed visit code 99203

Established Patient

$103.36 typical visit price

range $19.28 – $144.60

Typical copayment $25.84 (range $4.82 – $36.15)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. KURT DAYNE BAKER PH.D.

Psychologist (Clinical)

4125 BANGS AVE
MODESTO, CA 95356

Stanislaus County (209) 557-2300

DR. ANDREW DAVID MAMALIS MD

Student in an Organized Health Care Education/Training Program

4125 BANGS AVE
MODESTO, CA 95356

Stanislaus County (209) 735-5510

MS. LISA TEIXEIRA

Social Worker (Clinical)

4125 BANGS AVE
MODESTO, CA 95356

Stanislaus County (209) 557-2314

DR. MARY JESSIE SUMITHRA M.D

Pediatrics

4125 BANGS AVE
MODESTO, CA 95356

Stanislaus County (209) 557-1630

MARIA MARISSA DE LEON LIWAG MD

Pediatrics

4125 BANGS AVE
MODESTO, CA 95356

Stanislaus County (209) 551-3174

DR. BARBARA MARIE TODD PHD, MSCP

Psychologist (Clinical)

4125 BANGS AVE, DEPARTMENT OF PEDIATRICS, KAISER PERMANENTE
MODESTO, CA 95356

Stanislaus County (209) 557-1643

ANA LUISA CALLENDER LMFT

Counselor (Mental Health)

4125 BANGS AVE
MODESTO, CA 95356

Stanislaus County (209) 557-2309

SARAH AKIN RCP

Respiratory Therapist, Registered

4125 BANGS AVE
MODESTO, CA 95356

Stanislaus County (209) 824-4200

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Davis-marenco's NPI number?

The NPI number for Nicole Davis-marenco is 1114788767. It was assigned to this individual provider in the NPPES registry on January 22, 2024. The provider is also known as Nicole Renee Davis.

Where is Nicole Davis-marenco located?

Nicole Davis-marenco practices at 4125 Bangs Ave, Modesto, CA 95356. The listed phone number is (209) 735-5510.

What is Nicole Davis-marenco's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Nicole Davis-marenco enrolled in Medicare?

Yes. Nicole Davis-marenco is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicole Davis-marenco's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Davis-marenco reassigns Medicare benefits to 2 organizations: Leslie A. Storey, M.D., Inc. (Fresno, CA) and Sharp Rees-Stealy Medical Group, Inc (San Diego, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Nicole Davis-marenco's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Davis-marenco was last updated on January 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.