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STACY NICOLE NICOLE
NPI 1891516167
Nurse Practitioner in Fort Wayne, IN

Active since October 21, 2024PECOS EnrolledAccepts Medicare Assignment
3909 NEW VISION DR, FORT WAYNE, IN 46845(260) 469-6610(260) 969-3065 Get Directions Write a Review

NPPES record last updated: March 3, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Stacy Nicole Nicole NPPES

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

STACY NICOLE NICOLE (NPI 1891516167) is an individual nurse practitioner in Fort Wayne, Indiana, licensed in Indiana (71016044A) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS, is affiliated with Parkview Regional Medical Center, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1891516167
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameSTACY NICOLE NICOLE
Location Address3909 NEW VISION DRFort Wayne, IN 46845-1725
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Phone(260) 469-6610
Fax(260) 969-3065
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateOctober 21, 2024
Last NPPES UpdateMarch 3, 2025
NPPES CertifiedMarch 3, 2025
✔ NPI 1891516167 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in IN · 71016044A
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
Also ListedRegistered NurseTaxonomy 163W00000X · License 28147485A (IN)
3909 NEW VISION DR, Fort Wayne, IN 46845
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

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

Stacy Nicole Nicole 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 ID4385172469
PECOS Enrollment IDI20250117000420
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.

Hospital Affiliations CMS Care Compare 3

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

Parkview Regional Medical Center

Acute Care Hospitals · Fort Wayne, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150021
Location11109 Parkview Plaza DriveFort Wayne, IN 46845 · Allen County
Emergency services Birthing friendly

Parkview Dekalb Hospital

Acute Care Hospitals · Auburn, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number150045
Location1316 E Seventh StAuburn, IN 46706 · De Kalb County
Emergency services Birthing friendly

Parkview Noble Hospital

Acute Care Hospitals · Kendallville, IN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150146
Location401 Sawyer RdKendallville, IN 46755 · Noble County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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.

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.

MCKENNA A GOTTFRIED
Nurse Practitioner
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 425-5500
MS. DEBRA LAMMERS PA-C
Physician Assistant
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 469-6610
GREGORY L CHUPP MD
Family Medicine
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 469-6610
KARA YACKEE
Nurse Practitioner
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 469-6610
DR. MARY ANN O'BRIEN MD
Family Medicine
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 496-6602
GREG R JOHNSON DO
Internal Medicine (Nephrology)
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 469-6602
DR. JAMIE C BROEKHUIZEN D.O.
Family Medicine
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 469-6610
ALEXIS VICTORIA MOYER NURSE PRACTITIONER
Nurse Practitioner
3909 NEW VISION DR
FORT WAYNE, IN 46845
Allen County (260) 469-6610

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 Stacy Nicole's NPI number?

The NPI number for Stacy Nicole is 1891516167. It was assigned to this individual provider in the NPPES registry on October 21, 2024.

Where is Stacy Nicole located?

Stacy Nicole practices at 3909 New Vision Dr, Fort Wayne, IN 46845. The listed phone number is (260) 469-6610.

What is Stacy Nicole's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Stacy Nicole enrolled in Medicare?

Yes. Stacy Nicole is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Stacy Nicole accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Stacy Nicole 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.

Is Stacy Nicole affiliated with any hospitals?

According to CMS data, Stacy Nicole is affiliated with Parkview Regional Medical Center, Parkview Dekalb Hospital and Parkview Noble Hospital.

When was this NPI record last updated?

The NPPES record for Stacy Nicole was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.