NICOLE R GANNON ANP
NPI 1689947426
Nurse Practitioner - Adult Health in Orchard Park, NY

Q: What is Nicole Gannon's NPI number?

The NPI number for Nicole Gannon is 1689947426. It was assigned to this individual provider in the NPPES registry on February 9, 2012.

Q: What is Nicole Gannon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Gannon was last updated on October 10, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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 February 09, 2012PECOS Enrolled

3685 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127(716) 712-7555 Get Directions Write a Review

NPPES record last updated: October 10, 2024. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Oct 10, 2024, May 25, 2022 (2 updates tracked since 2022).

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About Nicole R Gannon Anp NPPES

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

NICOLE R GANNON ANP (NPI 1689947426) is an individual adult health provider in Orchard Park, New York, licensed in New York (F305960) and active in the NPI registry since February 2012. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689947426

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameNICOLE R GANNONCredential: ANP

Location Address3685 SOUTHWESTERN BLVDOrchard Park, NY 14127-1732

Mailing Address3685 Southwestern BlvdOrchard Park, NY 14127-1732 · (716) 712-7555

Phone(716) 712-7555

Sole ProprietorYes

Enumeration DateFebruary 9, 2012

Last NPPES UpdateOctober 10, 20242 updates tracked since enumeration

NPPES CertifiedOctober 10, 2024

✔ NPI 1689947426 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

Licenses✔ Licensed in NY · F305960✔ Licensed in NY · 305960

Also ListedNurse PractitionerTaxonomy 363L00000X · License 305960 (NY)

3685 SOUTHWESTERN BLVD, Orchard Park, NY 14127

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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)

Nicole R Gannon Anp 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.

Medicare Billing Reassignments

Medicare enrollment records show Nicole Gannon reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Wound Healing Solutions LLC

279 mi

Adult Health

600 CLEMENTS BRIDGE RD
Barrington, NJ 08007

Reassigned Medicare billing, New York enrollment
32 clinicians in this Medicare group

NPI 1225069966 (856) 547-8000

Brookview Medical Associates, PLLC

324 mi

General Practice

80 ORVILLE DR STE 100
Bohemia, NY 11716

Reassigned Medicare billing, New York enrollment
754 clinicians in this Medicare group

NPI 1871965855 (972) 715-3800

Senf Np Family Medicine PLLC

478 mi

Surgery

1901 N ROSELLE RD STE 800
Schaumburg, IL 60195

Reassigned Medicare billing, New York enrollment
54 clinicians in this Medicare group

NPI 1821702432 (443) 383-9300

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 14127 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

$84.93 typical visit price

range $54.87 – $166.88

Typical copayment $21.23 (range $13.71 – $41.72)

Most-billed visit code 99203

Established Patient

$97.08 typical visit price

range $17.54 – $136.14

Typical copayment $24.27 (range $4.38 – $34.03)

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.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Standard wheelchair K0001

DME-Wheelchairs · category DD000N

1 supplier11 claims11 services$12.72 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 11

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

CHRISTINA MANDOLFO RDN

Dietitian, Registered