NICHOLE BROEKHUIS RN, BSN, CRNP
NPI 1649851734
Nurse Practitioner - Pediatrics in Dayton, OH
About Nichole Broekhuis Rn, Bsn, Crnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
NICHOLE BROEKHUIS RN, BSN, CRNP (NPI 1649851734) is an individual pediatrics provider in Dayton, Ohio, licensed in Ohio (APRN.CNP0036317) and active in the NPI registry since April 2021. She is enrolled in Medicare PECOS and maintains a secondary practice location in Columbus.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Nichole Broekhuis Rn, Bsn, Crnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Nichole Broekhuis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Dayton, OH 45417
- Reassigned Medicare billing, Ohio enrollment
- 85 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 45417 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
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 Nichole Broekhuis's NPI number?
The NPI number for Nichole Broekhuis is 1649851734. It was assigned to this individual provider in the NPPES registry on April 20, 2021.
Where is Nichole Broekhuis located?
Nichole Broekhuis practices at 721 Miami Chapel Rd, Dayton, OH 45417. The listed phone number is (937) 281-6800.
What is Nichole Broekhuis's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Nichole Broekhuis enrolled in Medicare?
Yes. Nichole Broekhuis is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Nichole Broekhuis's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nichole Broekhuis reassigns Medicare benefits to Five Rivers Health Centers (Dayton, OH). 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 Nichole Broekhuis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Nichole Broekhuis accept?
Health plans from CareSource, MedMutual and UnitedHealthcare list Nichole Broekhuis 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 Nichole Broekhuis was last updated on April 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.
# Nichole Broekhuis, RN, BSN, CRNP · NPI 1649851734
Pediatrics physician in Dayton, Ohio. Individual provider, active in the CMS NPPES registry since April 20, 2021.
## Identity
- **NPI:** 1649851734 (Entity type: Individual)
- **Enumerated:** April 20, 2021
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** APRN.CNP0036317 (Ohio)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 721 MIAMI CHAPEL RD, Dayton, OH 45417-4650
- **Phone:** (937) 281-6800
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Five Rivers Health Centers (NPI 1669143061, Dayton, OH), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 6, 2026
---
Source: [NPI Profile](https://npiprofile.com/npi/1649851734) · Data from the CMS NPPES public registry.