NICOLE R WILDROUDT LPCC
NPI 1235526096
Counselor - Professional in Kokomo, IN
About Nicole R Wildroudt Lpcc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICOLE R WILDROUDT LPCC (NPI 1235526096) is an individual professional provider in Kokomo, Indiana, licensed in Arizona (LPC-24135) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Nicole R Wildroudt Lpcc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Nicole Wildroudt reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Tucson, AZ 85716
- Reassigned Medicare billing, Arizona enrollment
- 464 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Wildroudt's NPI number?
The NPI number for Nicole Wildroudt is 1235526096. It was assigned to this individual provider in the NPPES registry on April 20, 2015.
Where is Nicole Wildroudt located?
Nicole Wildroudt practices at 4104 Springmill Dr, Kokomo, IN 46902. The listed phone number is (937) 554-3667.
What is Nicole Wildroudt's specialty?
The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.
Is Nicole Wildroudt enrolled in Medicare?
Yes. Nicole Wildroudt is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Nicole Wildroudt's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Wildroudt reassigns Medicare benefits to El Rio Santa Cruz Neighborhood Health Center, Inc (Tucson, AZ). 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 Wildroudt's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nicole Wildroudt accept?
Health plans from Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Arizona, CareSource, Cigna HealthCare of Arizona, Inc and Oscar Health Plan, Inc. and 1 other insurer list Nicole Wildroudt as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Nicole Wildroudt was last updated on July 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Nicole R Wildroudt, LPCC · NPI 1235526096
Professional provider in Kokomo, Indiana. Individual provider, active in the CMS NPPES registry since April 20, 2015.
## Identity
- **NPI:** 1235526096 (Entity type: Individual)
- **Enumerated:** April 20, 2015
- **Primary specialty:** Counselor - Professional · taxonomy 101YP2500X
- **State license:** LPC-24135 (Arizona)
- **Sole proprietor:** No
## Practice location
- **Address:** 4104 SPRINGMILL DR, Kokomo, IN 46902-5168
- **Phone:** (937) 554-3667
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** El Rio Santa Cruz Neighborhood Health Center, Inc (NPI 1477204485, Tucson, AZ), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** July 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1235526096) · Data from the CMS NPPES public registry.