Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

NICOLE JENE FENNIMORE MD
NPI 1922569748
Obstetrics & Gynecology in Madison, WI

Q: What is Nicole Fennimore's NPI number?

The NPI number for Nicole Fennimore is 1922569748. It was assigned to this individual provider in the NPPES registry on March 26, 2019.

Q: What is Nicole Fennimore's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Q: When was this NPI record last updated?

The NPPES record for Nicole Fennimore was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 25 days 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 26, 2019PECOS Enrolled

84.64/100

CMS Quality Rating

2402 WINNEBAGO ST, MADISON, WI 53704(608) 914-2200(608) 245-6117 Get Directions Write a Review

NPPES record last updated: September 17, 2026. Verified against the NPPES registry weekly; last sync: October 04, 2026.

Record update history: Sep 17, 2026, Oct 23, 2023 (2 updates tracked since 2023).

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About Nicole Jene Fennimore Md NPPES

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

NICOLE JENE FENNIMORE MD (NPI 1922569748) is an individual obstetrics & gynecology provider in Madison, Wisconsin, licensed in Wisconsin (87424-20) and active in the NPI registry since March 2019. She is enrolled in Medicare PECOS, is affiliated with Hshs St Elizabeth's Hospital, and maintains a secondary practice location in Portland.

NPPES Registry Identity

NPI1922569748

Entity TypeIndividualFemale

Primary Taxonomy207V00000X

Provider Legal NameNICOLE JENE FENNIMORECredential: MD

Location Address2402 WINNEBAGO STMadison, WI 53704-5341

Mailing Address7974 Uw Health CtMiddleton, WI 53562-5531

Phone(608) 914-2200

Fax(608) 245-6117

Sole ProprietorNo

Medical School CMSUniversity Of Wisconsin School Of MedicineGraduated 2019

Enumeration DateMarch 26, 2019

Last NPPES UpdateSeptember 17, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 17, 2026

✔ NPI 1922569748 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians

Taxonomy Code207V00000X

Licenses✔ Licensed in WI · 87424-20✔ Licensed in OR · MD205498

Definition

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

2402 WINNEBAGO ST, Madison, WI 53704

Open in Google Maps ↗

Secondary Practice Location 1

Location 110101 SE Main St Ste 3001Portland, OR 97216-2458 · Phone (503) 261-4423 · Fax (503) 261-4424

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc..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 Jene Fennimore Md 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 ID2264769207

PECOS Enrollment IDI20250916003127

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

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

Hshs St Elizabeth's Hospital

Acute Care Hospitals · O Fallon, IL

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140187

LocationOne St Elizabeth BoulevardO Fallon, IL 62269 · St. Clair County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53704 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

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

84.64/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

80.94

Promoting Interoperability

100

Improvement Activities

Cost

62.46

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.

MARIANA LEE MONTERO JAQUES MD

Pediatrics