Souphaphone Nicksic, CRNA
NPI 1740425701 · Certified Registered Nurse Anesthetist · Elgin, IL
Enrolled with Medicare as Practitioner - Certified Registered Nurse Anesthetist (crna) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1740425701
- Entity type
- Individual
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CRNA
- Sex
- Female
- Sole proprietor
- No
- License
- 28181986A (IN)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
17 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
3 documented practice locations
- Medicare service volume (vs. specialty peers)28% of score
62 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Anesthesia for Lens Surgery00142 | 25 | $106 |
| Anesthesia for Other Procedure on Large Bowel Using an Endoscope00811 | 19 | $121 |
| Anesthesia for Procedure on Small and Large Bowel Using an Endoscope00813 | 18 | $152 |
Typical Medicare-allowed amounts for these services range $106–$152 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Additional practice locations (2)
- 2475 Dean StSaint Charles, IL 60175-4831Phone: (630) 584-9800
- 2600 Greenbush StLafayette, IN 47904-2477Phone: (765) 448-8000
Registry dates
- Enumerated
- 2008-12-04
- Last updated
- 2023-08-30
- Certified
- 2023-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.