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NICOLE MARIE FETZER CRNA
NPI 1902105273
Nurse Anesthetist, Certified Registered in Liverpool, NY

Active since March 25, 2011
74.41/100
CMS Quality Rating
225 GREENFIELD PKWY STE 105, LIVERPOOL, NY 13088(315) 451-6911(315) 451-1540 Get Directions Write a Review

NPPES record last updated: July 22, 2023. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 22, 2023, Oct 31, 2019 (2 updates tracked since 2019).

About Nicole Marie Fetzer Crna NPPES

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

NICOLE MARIE FETZER CRNA (NPI 1902105273) is an individual nurse anesthetist, certified registered in Liverpool, New York, licensed in New York (543801) and active in the NPI registry since March 2011. She maintains 2 additional practice locations.

NPPES Registry Identity

NPI1902105273
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameNICOLE MARIE FETZERCredential: CRNA
Location Address225 GREENFIELD PKWY STE 105Liverpool, NY 13088
Mailing AddressPo Box 2337Syracuse, NY 13220-2337 · (315) 422-6705 · Fax (315) 422-3909
Phone(315) 451-6911
Fax(315) 451-1540
Sole ProprietorNo
Enumeration DateMarch 25, 2011
Last NPPES UpdateJuly 22, 20232 updates tracked since enumeration
✔ NPI 1902105273 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in NY · 543801
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
Also ListedInternal MedicineTaxonomy 207R00000X · License 543801 (NY)
225 GREENFIELD PKWY STE 105, Liverpool, NY 13088
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Secondary Practice Locations 2

Location 1225 Greenfield Pkwy Ste 105Liverpool, NY 13088 · Phone (315) 451-6911 · Fax (315) 451-1540
Location 24900 Broad RdSyracuse, NY 13215-2265 · Phone (315) 492-5522

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

Medicare Billing Reassignments

4

Medicare enrollment records show Nicole Fetzer reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Oswego Hospital
31 mi
Anesthesiology
110 W 6TH ST
Oswego, NY 13126
  • Reassigned Medicare billing, New York enrollment
  • 122 clinicians in this Medicare group
NPI 1255639043 (315) 349-5511
Great Lakes Surgical Associates, P.C.
127 mi
Surgery
160 EAST AVE
Lockport, NY 14094
  • Reassigned Medicare billing, New York enrollment
  • 8 clinicians in this Medicare group
NPI 1851574024 (716) 434-6141
Parkside Medical Anesthesia Associates
136 mi
Anesthesiology
2157 MAIN STREET
Buffalo, NY 14214
  • Reassigned Medicare billing, New York enrollment
  • 117 clinicians in this Medicare group
NPI 1871537464 (716) 836-7510
Great Lakes Anesthesiology, PC
137 mi
Specialist
818 ELLICOTT ST
Buffalo, NY 14203
  • Reassigned Medicare billing, New York enrollment
  • 182 clinicians in this Medicare group
NPI 1306852181 (716) 323-6570

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

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

74.41/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality76.58
Promoting Interoperability100
Improvement Activities40
Cost16.86

Other Providers at the Same Location NPPES 2

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

SYRACUSE ASC LLC
Anesthesiology
225 GREENFIELD PKWY STE 105
LIVERPOOL, NY 13088
Onondaga County (315) 451-6911
ARTURO MEDINA CASTRO
Anesthesiology
225 GREENFIELD PKWY STE 105
LIVERPOOL, NY 13088
Onondaga County (315) 451-6911

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 Fetzer's NPI number?

The NPI number for Nicole Fetzer is 1902105273. It was assigned to this individual provider in the NPPES registry on March 25, 2011.

Where is Nicole Fetzer located?

Nicole Fetzer practices at 225 Greenfield Pkwy Ste 105, Liverpool, NY 13088. The listed phone number is (315) 451-6911.

What is Nicole Fetzer's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Nicole Fetzer enrolled in Medicare?

Yes. Nicole Fetzer is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Nicole Fetzer's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Fetzer reassigns Medicare benefits to 4 organizations: Oswego Hospital (Oswego, NY), Great Lakes Surgical Associates, P.C. (Lockport, NY), Parkside Medical Anesthesia Associates (Buffalo, NY) and Great Lakes Anesthesiology, PC (Buffalo, NY). Each 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 Fetzer's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Nicole Fetzer was last updated on July 22, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.