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NICOLE CAUGHERTY HAN
NPI 1801359872
Clinical Neuropsychologist in Grand Rapids, MI

Active since April 08, 2019PECOS Enrolled
3292 N EVERGREEN DR NE, GRAND RAPIDS, MI 49525(616) 365-8920 Get Directions Write a Review

NPPES record last updated: September 22, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 11, 2022, Apr 8, 2019 (2 updates tracked since 2019).

About Nicole Caugherty Han NPPES

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

NICOLE CAUGHERTY HAN (NPI 1801359872) is an individual clinical neuropsychologist in Grand Rapids, Michigan and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phoenix, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1801359872
Entity TypeIndividualFemale
Primary Taxonomy103G00000X
Provider Legal NameNICOLE CAUGHERTY HAN
Location Address3292 N EVERGREEN DR NEGrand Rapids, MI 49525-9746
Mailing Address300 68th St SeGrand Rapids, MI 49548-6927 · (616) 455-5000
Phone(616) 365-8920
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 8, 2019
Last NPPES UpdateSeptember 22, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 22, 2025
✔ NPI 1801359872 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
Also ListedPsychologist · ClinicalTaxonomy 103TC0700X · License 6301019400 (MI)
3292 N EVERGREEN DR NE, Grand Rapids, MI 49525
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Secondary Practice Location 1

Location 11919 E Thomas RdPhoenix, AZ 85016-7710 · Phone (602) 933-1000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID6002305521
PECOS Enrollment IDI20251027000370
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 Reassignment

Medicare enrollment records show Nicole Caugherty Han reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Pine Rest Christian Mental Health Services
13 mi
Professional
300 68TH ST SE
Grand Rapids, MI 49548
  • Reassigned Medicare billing, Michigan enrollment
  • 135 clinicians in this Medicare group
NPI 1386015683 (616) 281-6372

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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.

NANCY HAMSTREET LMSW
Social Worker (School)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
RENEE ORR LMSW
Social Worker
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
STEPHANIE BROWN
Social Worker (Clinical)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
KENDRA-MARIE MADDISON GARCIA MD, BCBA, LBA
Behavior Analyst
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
KRESTIN RADONOVICH PHD
Psychologist (Clinical)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
VANESSA PRUITT DLLP
Psychologist
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
LAUREN VANDRUNEN LMSW
Social Worker (Clinical)
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920
MATTHEW SCOTT PETTINGA MA, LPC
Counselor
3292 N EVERGREEN DR NE
GRAND RAPIDS, MI 49525
Kent County (616) 365-8920

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 Caugherty Han's NPI number?

The NPI number for Nicole Caugherty Han is 1801359872. It was assigned to this individual provider in the NPPES registry on April 8, 2019.

Where is Nicole Caugherty Han located?

Nicole Caugherty Han practices at 3292 N Evergreen Dr NE, Grand Rapids, MI 49525. The listed phone number is (616) 365-8920.

What is Nicole Caugherty Han's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is Nicole Caugherty Han enrolled in Medicare?

Yes. Nicole Caugherty Han is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Nicole Caugherty Han's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Caugherty Han reassigns Medicare benefits to Pine Rest Christian Mental Health Services (Grand Rapids, MI). 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 Nicole Caugherty Han's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Nicole Caugherty Han accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company, Priority Health and UnitedHealthcare list Nicole Caugherty Han 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 Caugherty Han was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.