NICOLE KANOMATA FNP
NPI 1366165102
Nurse Practitioner - Family in Manistee, MI

Q: What is Nicole Kanomata's NPI number?

The NPI number for Nicole Kanomata is 1366165102. It was assigned to this individual provider in the NPPES registry on September 26, 2022.

Q: What is Nicole Kanomata's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Kanomata was last updated on January 15, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since September 26, 2022PECOS EnrolledAccepts Medicare Assignment

1465 E PARKDALE AVE, MANISTEE, MI 49660(231) 876-6421(231) 876-6430 Get Directions Write a Review

NPPES record last updated: January 15, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 16, 2022, Sep 26, 2022 (2 updates tracked since 2022).

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About Nicole Kanomata Fnp NPPES

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

NICOLE KANOMATA FNP (NPI 1366165102) is an individual family provider in Manistee, Michigan, licensed in Michigan (F10220404) and active in the NPI registry since September 2022. She is enrolled in Medicare PECOS, is affiliated with Munson Healthcare Cadillac Hospital, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1366165102

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameNICOLE KANOMATACredential: FNP

Location Address1465 E PARKDALE AVEManistee, MI 49660-9709

Mailing Address1105 Sixth StTraverse City, MI 49684-2386

Phone(231) 876-6421

Fax(231) 876-6430

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateSeptember 26, 2022

Last NPPES UpdateJanuary 15, 20252 updates tracked since enumeration

NPPES CertifiedJanuary 15, 2025

✔ NPI 1366165102 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in MI · F10220404

1465 E PARKDALE AVE, Manistee, MI 49660

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Secondary Practice Locations 2

Location 1400 Hobart StCadillac, MI 49601-2331 · Phone (231) 876-6421 · Fax (231) 876-6430

Location 2217 S Madison StTraverse City, MI 49684-2321 · Phone (231) 392-8400 · Fax (231) 392-8467

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Nicole Kanomata Fnp 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.

PECOS PAC ID5092184259

PECOS Enrollment IDI20221209000521

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.

Areas of Expertise CMS Part B claims 3

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.

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

26 services15 patients

Residence visit for established patient with moderate level of medical decision making, per day, if using time, at least 40 minutes 99349

An established patient home visit is a medical appointment conducted at your home, typically lasting around 40 minutes. This service is ideal for patients who may find it difficult to travel to a healthcare facility. During this visit, a healthcare professional will evaluate your health status, manage your care, and answer any health-related questions you may have.

22 services14 patients

Residence visit for new patient with moderate level of medical decision making, per day, if using time, at least 60 minutes 99344

A new patient home visit is a comprehensive service where a healthcare professional visits your home for about an hour. This visit includes an overall health assessment, discussion about your medical history, and planning for future healthcare needs. The goal is to understand your health status and provide personalized care.

12 services12 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Munson Healthcare Cadillac Hospital

Acute Care Hospitals · Cadillac, MI

5/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number230081

Location400 Hobart StCadillac, MI 49601 · Wexford County

Emergency services Birthing friendly

Munson Healthcare Manistee Hospital

Acute Care Hospitals · Manistee, MI

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number230303

Location1465 E Parkdale AveManistee, MI 49660 · Manistee County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49660 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

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.

SHANE LINKE

Pharmacist