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NICOLE DANIELLE CARRILLO RN, MS, ACNP
NPI 1114934346
Nurse Practitioner - Critical Care Medicine in San Francisco, CA

Active since August 01, 2006PECOS Enrolled
623 BRODERICK ST, SAN FRANCISCO, CA 94117(415) 921-9110 Get Directions Write a Review

NPPES record last updated: December 30, 2021. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Nicole Danielle Carrillo Rn, Ms, Acnp NPPES

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

NICOLE DANIELLE CARRILLO RN, MS, ACNP (NPI 1114934346) is an individual critical care medicine provider in San Francisco, California, licensed in California (NP14993) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1114934346
Entity TypeIndividualFemale
Primary Taxonomy363LC0200X
Provider Legal NameNICOLE DANIELLE CARRILLOCredential: RN, MS, ACNP
Location Address623 BRODERICK STSan Francisco, CA 94117-1590
Mailing Address623 Broderick St, Apartment ASan Francisco, CA 94117-1590 · (415) 921-9110
Phone(415) 921-9110
Sole ProprietorNo
Enumeration DateAugust 1, 2006
Last NPPES UpdateDecember 30, 2021
✔ NPI 1114934346 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Critical Care MedicinePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LC0200X
License✔ Licensed in CA · NP14993
623 BRODERICK ST, San Francisco, CA 94117
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Danielle Carrillo Rn, Ms, Acnp 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 Reassignment

Medicare enrollment records show Nicole Carrillo reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Permanente Medical Group Inc
0.5 mi
Internal Medicine
2238 GEARY
San Francisco, CA 94116
  • Reassigned Medicare billing, California enrollment
  • 20,078 clinicians in this Medicare group
NPI 1841373800 (415) 833-2200

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 94117 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$119.48 typical visit price
range $23.44 – $166.46
Typical copayment $29.87 (range $5.86 – $41.61)
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.

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 Carrillo's NPI number?

The NPI number for Nicole Carrillo is 1114934346. It was assigned to this individual provider in the NPPES registry on August 1, 2006.

Where is Nicole Carrillo located?

Nicole Carrillo practices at 623 Broderick St, San Francisco, CA 94117. The listed phone number is (415) 921-9110.

What is Nicole Carrillo's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Critical Care Medicine, with taxonomy code 363LC0200X.

Is Nicole Carrillo enrolled in Medicare?

Yes. Nicole Carrillo is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Carrillo's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Carrillo reassigns Medicare benefits to Permanente Medical Group Inc (San Francisco, CA). The 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 Carrillo'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 Carrillo was last updated on December 30, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.