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NICOLE ROSS PMHNP
NPI 1467279364
Nurse Practitioner - Psychiatric/Mental Health in South Bend, IN

Active since September 23, 2024PECOS EnrolledAccepts Medicare Assignment
3606 E JEFFERSON BLVD, SOUTH BEND, IN 46615(463) 724-3416(574) 323-3718 Get Directions Write a Review

NPPES record last updated: May 27, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: May 27, 2025, Sep 23, 2024 (2 updates tracked since 2024).

About Nicole Ross Pmhnp NPPES

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

NICOLE ROSS PMHNP (NPI 1467279364) is an individual psychiatric/mental health provider in South Bend, Indiana, licensed in Indiana (28223419A) and active in the NPI registry since September 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1467279364
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameNICOLE ROSSCredential: PMHNP
Location Address3606 E JEFFERSON BLVDSouth Bend, IN 46615-3052
Mailing Address729 S Wellington StSouth Bend, IN 46619-2924 · (574) 323-3718
Phone(463) 724-3416
Fax(574) 323-3718
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateSeptember 23, 2024
Last NPPES UpdateMay 27, 20252 updates tracked since enumeration
NPPES CertifiedMay 27, 2025
✔ NPI 1467279364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in IN · 28223419A
3606 E JEFFERSON BLVD, South Bend, IN 46615
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health 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 Ross Pmhnp 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 ID2163957077
PECOS Enrollment IDI20241129000233
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46615 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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 4

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

ORANGE COUNTY PSYCHIATRY AND ADDICTION MEDICINE
Psychiatry & Neurology (Psychiatry)
3606 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (949) 515-7300
RACHAEL ELIZABETH AMOR MASTERS IN SOCIAL WO
Counselor (Addiction (Substance Use Disorder))
3606 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (866) 486-9769
CARDINAL RECOVERY LLC
Substance Abuse Rehabilitation Facility
3606 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (657) 304-0103
CHOICES RECOVERY
Substance Abuse Rehabilitation Facility
3606 E JEFFERSON BLVD
SOUTH BEND, IN 46615
St. Joseph County (574) 217-7769

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 Ross's NPI number?

The NPI number for Nicole Ross is 1467279364. It was assigned to this individual provider in the NPPES registry on September 23, 2024.

Where is Nicole Ross located?

Nicole Ross practices at 3606 E Jefferson Blvd, South Bend, IN 46615. The listed phone number is (463) 724-3416.

What is Nicole Ross's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Nicole Ross enrolled in Medicare?

Yes. Nicole Ross 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.

What insurance does Nicole Ross accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Nicole Ross 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 Ross was last updated on May 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.