NICOLE FENNELL
NPI 1639626724
Physician Assistant in Coos Bay, OR

Q: What is Nicole Fennell's NPI number?

The NPI number for Nicole Fennell is 1639626724. It was assigned to this individual provider in the NPPES registry on September 6, 2016.

Q: What is Nicole Fennell's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Fennell was last updated on September 6, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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 06, 2016PECOS Enrolled

1775 THOMPSON RD, COOS BAY, OR 97420(541) 269-8111 Get Directions Write a Review

NPPES record last updated: September 6, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Nicole Fennell NPPES

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

NICOLE FENNELL (NPI 1639626724) is an individual physician assistant in Coos Bay, Oregon, licensed in Oregon (PA179333) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639626724

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameNICOLE FENNELL

Location Address1775 THOMPSON RDCoos Bay, OR 97420-2125

Mailing Address1775 Thompson RdCoos Bay, OR 97420-2125 · (541) 269-8111

Phone(541) 269-8111

Sole ProprietorNo

Enumeration DateSeptember 6, 2016

✔ NPI 1639626724 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in OR · PA179333

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1775 THOMPSON RD, Coos Bay, OR 97420

Open in Google Maps ↗

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Nicole Fennell is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 6

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.

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

168 services167 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

133 services128 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

99 services97 patients

Simple repair of surface wound of scalp, neck, underarms, trunk, arms, or legs, 2.6-7.5 cm 12002

This is a procedure to mend a surface wound measuring between 2.6-7.5 cm on your scalp, neck, underarms, trunk, arms, or legs. It involves cleaning, closing and dressing the wound to promote healing and prevent infection.

21 services21 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

18 services18 patients

Simple repair of surface wound of face, ears, eyelids, nose, lips, or mouth, 2.6-5.0 cm 12013

This procedure involves the repair of a surface wound on your face, ears, eyelids, nose, lips, or mouth. The wound size is between 2.6-5.0 cm. The process includes cleaning the wound and stitching it up to promote healing and minimize scarring.

11 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97420 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

$84.82 typical visit price

range $54.96 – $166.64

Typical copayment $21.20 (range $13.74 – $41.66)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.68 – $136.19

Typical copayment $17.16 (range $4.42 – $34.04)

Most-billed visit code 99213

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.

ERIN DANIELSON

Pharmacist