NICOLE RENEE NISSEN
NPI 1629569843
Nurse Practitioner - Family in Waterloo, IL

Q: What is Nicole Nissen's NPI number?

The NPI number for Nicole Nissen is 1629569843. It was assigned to this individual provider in the NPPES registry on May 23, 2018.

Q: What is Nicole Nissen'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 Nissen was last updated on April 17, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since May 23, 2018PECOS EnrolledAccepts Medicare Assignment

67.56/100

CMS Quality Rating

623 HAMACHER ST, WATERLOO, IL 62298(314) 925-0903 Get Directions Write a Review

NPPES record last updated: April 17, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 17, 2022, Aug 20, 2018, May 23, 2018 (3 updates tracked since 2018).

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About Nicole Renee Nissen NPPES

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

NICOLE RENEE NISSEN (NPI 1629569843) is an individual family provider in Waterloo, Illinois, licensed in Missouri (2018012260) and active in the NPI registry since May 2018. She is enrolled in Medicare PECOS, is affiliated with Red Bud Regional Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1629569843

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameNICOLE RENEE NISSEN

Location Address623 HAMACHER STWaterloo, IL 62298-1786

Mailing Address10426 Baur BlvdSaint Louis, MO 63132-1905 · (314) 925-0903

Phone(314) 925-0903

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateMay 23, 2018

Last NPPES UpdateApril 17, 20253 updates tracked since enumeration

NPPES CertifiedApril 17, 2025

✔ NPI 1629569843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

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

Taxonomy Code363LF0000X

License✔ Licensed in MO · 2018012260

Also ListedNurse PractitionerTaxonomy 363L00000X · License 209017442 (IL)

623 HAMACHER ST, Waterloo, IL 62298

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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 Renee Nissen 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 ID547519423

PECOS Enrollment IDI20180827001542, I20180910002278

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 7

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.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

289 services58 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

264 services37 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

159 services54 patients

Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232

Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.

57 services40 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

30 services11 patients

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223

Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.

27 services26 patients

Hospital Affiliations CMS Care Compare

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

Red Bud Regional Hospital

Critical Access Hospitals · Red Bud, IL

OwnershipProprietary

CMS Certification Number141348

Location325 Spring StreetRed Bud, IL 62278 · Randolph County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62298 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

$88.44 typical visit price

range $56.28 – $173.35

Typical copayment $22.11 (range $14.07 – $43.33)

Most-billed visit code 99203

Established Patient

$99.71 typical visit price

range $17.51 – $139.99

Typical copayment $24.92 (range $4.37 – $34.99)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

67.56/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

36.19

Improvement Activities

Cost

43.61

Other Providers at the Same Location NPPES 12

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

MRS. JENNIFER REBECCA EVANS OTR/L

Occupational Therapist