NICOLE DEROSE CRNP
NPI 1922492735
Nurse Practitioner - Primary Care in Wynnewood, PA

Q: What is Nicole Derose's NPI number?

The NPI number for Nicole Derose is 1922492735. It was assigned to this individual provider in the NPPES registry on March 19, 2015.

Q: What is Nicole Derose's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Derose was last updated on March 19, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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 March 19, 2015PECOS EnrolledAccepts Medicare Assignment

100 E LANCASTER AVE, SUITE 230, WYNNEWOOD, PA 19096(610) 642-3796(610) 642-2943 Get Directions Write a Review

NPPES record last updated: March 19, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Nicole Derose Crnp NPPES

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

NICOLE DEROSE CRNP (NPI 1922492735) is an individual primary care provider in Wynnewood, Pennsylvania, licensed in Pennsylvania (SP014550) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS, is affiliated with Thomas Jefferson University Hospital, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1922492735

Entity TypeIndividualFemale

Primary Taxonomy363LP2300X

Provider Legal NameNICOLE DEROSECredential: CRNP

Location Address100 E LANCASTER AVE, SUITE 230Wynnewood, PA 19096-3450

Mailing Address100 E Lancaster Ave, Suite 230Wynnewood, PA 19096-3450 · (610) 642-3796 · Fax (610) 642-2943

Phone(610) 642-3796

Fax(610) 642-2943

Sole ProprietorNo

Medical School CMSOtherGraduated 2014

Enumeration DateMarch 19, 2015

✔ NPI 1922492735 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP2300X

License✔ Licensed in PA · SP014550

100 E LANCASTER AVE, Wynnewood, PA 19096

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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 Health, Ambetter Health of Delaware.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

Nicole Derose Crnp 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 ID4587942008

PECOS Enrollment IDI20161103000172

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

117 services49 patients

Face-to-face behavioral counseling for obesity, 15 minutes G0447

This is a 15-minute consultation where a healthcare professional discusses your eating habits, physical activity, and goals to help manage your weight. The aim is to provide personalized strategies to promote a healthier lifestyle and combat obesity.

92 services43 patients

Hospital Affiliations CMS Care Compare

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

Thomas Jefferson University Hospital

Acute Care Hospitals · Philadelphia, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390174

Location111 South 11th StreetPhiladelphia, PA 19107 · Philadelphia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19096 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$105.21 typical visit price

range $19.30 – $147.29

Typical copayment $26.30 (range $4.82 – $36.82)

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 11

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

Tubing with integrated heating element for use with positive airway pressure device A4604