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KATHERINE E NICOLICH DO
NPI 1417709379
Student in an Organized Health Care Education/Training Program in Coeur D Alene, ID

Active since April 03, 2024PECOS Enrolled
1919 LINCOLN WAY, COEUR D ALENE, ID 83814(208) 625-6000 Get Directions Write a Review

NPPES record last updated: January 6, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 6, 2026, Apr 3, 2024 (2 updates tracked since 2024).

About Katherine E Nicolich Do NPPES

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

KATHERINE E NICOLICH DO (NPI 1417709379) is an individual student in an organized health care education/training program in Coeur D Alene, Idaho and active in the NPI registry since April 2024. She is enrolled in Medicare PECOS, is affiliated with Kootenai Health, and is a graduate of Rocky Vista University College Of Osteopathic Med (2024).

NPPES Registry Identity

NPI1417709379
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameKATHERINE E NICOLICHCredential: DO
Location Address1919 LINCOLN WAYCoeur D Alene, ID 83814-2527
Mailing Address31630 S Hackberry LnOracle, AZ 85623-7534 · (208) 597-2743
Phone(208) 625-6000
Sole ProprietorNo
Medical School CMSRocky Vista University College Of Osteopathic MedGraduated 2024
Enumeration DateApril 3, 2024
Last NPPES UpdateJanuary 6, 20262 updates tracked since enumeration
NPPES CertifiedJanuary 6, 2026
✔ NPI 1417709379 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
1919 LINCOLN WAY, Coeur D Alene, ID 83814
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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)

Katherine E Nicolich Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2860911500
PECOS Enrollment IDI20260817002990
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 Katherine Nicolich reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Kootenai Health, Inc.
0.2 mi
Psychiatry
2003 KOOTENAI HEALTH WAY
Coeur D Alene, ID 83814
  • Reassigned Medicare billing, Idaho enrollment
  • 472 clinicians in this Medicare group
NPI 1174661151 (208) 625-4000

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

Hospital Affiliations CMS Care Compare 2

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

Kootenai Health

Acute Care Hospitals · Coeur D'alene, ID
4/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number130049
Location2003 Kootenai Health WayCoeur D'alene, ID 83814 · Kootenai County
Emergency services Birthing friendly

St Luke's Mccall

Critical Access Hospitals · Mccall, ID
OwnershipProprietary
CMS Certification Number131312
Location1000 State StreetMccall, ID 83638 · Valley County
Emergency services Birthing friendly

Other Providers at the Same Location NPPES 16

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

RYAN JOHN GILLES MD
Family Medicine
1919 LINCOLN WAY, 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
CRYSTAL LEE PYRAK MD
Family Medicine
1919 LINCOLN WAY, STE 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
DR. MARIA R RODEBAUGH MD
Internal Medicine (Endocrinology, Diabetes & Metabolism)
1919 LINCOLN WAY, 211
COEUR D ALENE, ID 83814
Kootenai County (208) 625-5500
MARIE NOEL SWART MD
Student in an Organized Health Care Education/Training Program
1919 LINCOLN WAY
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
MR. TIMOTHY JAMES DOTY PA
Physician Assistant
1919 LINCOLN WAY, 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
DR. KEVIN ROBERT WEBB M.D.
Internal Medicine (Gastroenterology)
1919 LINCOLN WAY, STE 415
COEUR D ALENE, ID 83814
Kootenai County (208) 625-4595
JONATHAN MOORE SHUPE M.D.
Family Medicine
1919 LINCOLN WAY, 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000
BRITTANY T FICEK FNP
Nurse Practitioner
1919 LINCOLN WAY, 315
COEUR D ALENE, ID 83814
Kootenai County (208) 625-6000

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 Katherine Nicolich's NPI number?

The NPI number for Katherine Nicolich is 1417709379. It was assigned to this individual provider in the NPPES registry on April 3, 2024.

Where is Katherine Nicolich located?

Katherine Nicolich practices at 1919 Lincoln Way, Coeur D Alene, ID 83814. The listed phone number is (208) 625-6000.

What is Katherine Nicolich's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Katherine Nicolich enrolled in Medicare?

Yes. Katherine Nicolich is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Katherine Nicolich's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Katherine Nicolich reassigns Medicare benefits to Kootenai Health, Inc. (Coeur D Alene, ID). 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 Katherine Nicolich's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Katherine Nicolich affiliated with any hospitals?

According to CMS data, Katherine Nicolich is affiliated with Kootenai Health and St Luke's Mccall.

When was this NPI record last updated?

The NPPES record for Katherine Nicolich was last updated on January 6, 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.