Souphaphone Bounmythavong Nicksic, CRNA
Certified Registered Nurse Anesthetist · Elgin, IL
Souphaphone Bounmythavong Nicksic, CRNA is a certified registered nurse anesthetist with a practice address in Elgin, Illinois, and NPI 1740425701, issued on Dec 4, 2008. Check the license (Illinois 209008677, as entered in NPPES) with the Illinois board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Souphaphone Bounmythavong Nicksic
- Credential
- CRNA
- Primary taxonomy
- Certified Registered Nurse Anesthetist 367500000X
- License numbers
- 209008677 IL
28181986A IN
Self-reported in NPPES; status is on the state search - Practice location
- 1425 N Randall RD, Elgin, IL 60123
- Phone
- (224) 783-1065
- Enumerated
- Dec 4, 2008
- Record last updated
- Aug 30, 2023
- Fax
- (224) 783-2852
- Medicaid ID
- 200949460 IN
- Medicare enrollment
- Enrolled (PECOS I20120323000591); accepts Medicare assignment
- Entity
- Type 1 · individual
8 nearest certified registered nurse anesthetist records → All 2,444 in Illinois → Look up another NPI →
Also registered at 1425 N Randall RD
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Julie Anderson, D.O.Pediatrics Physician1124438783
- Danilo Aparicio Fernandez, M.D.Internal Medicine Physician1184019564
- Dalia Ascencio Yanez, APNFamily Nurse Practitioner1285091934
- Amanda AugerRegistered Dietitian1992670061
- Joanna Barclay, MDPain Medicine (Anesthesiology) Physician1932210978
- Jennifer Barham, ANP-BCAdult Health Nurse Practitioner1184987497
Verify Souphaphone Bounmythavong Nicksic in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Illinois board licenses this profession
Search for license 209008677Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
The MIPS final score for 2023 (Medicare payment program): 99.5 of 100
The Merit-based Incentive Payment System score is reported for this clinician. Four categories are weighted into the final score; the average among 454,083 clinicians with a measured score was 83.5.
Source: CMS Quality Payment Program, MIPS performance year 2023; category weights for 2023 (qpp.cms.gov).
Bills Medicare through one group practice
- Advocate Health And Hospitals CorporationElgin, IL
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Souphaphone Bounmythavong Nicksic among 2,444 certified registered nurse anesthetist records in Illinois
Souphaphone Bounmythavong Nicksic, CRNA is one of 2,444 certified registered nurse anesthetist records with a practice address in Illinois. 82% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2008, is newer than 34% of them.
- NPI issued2008 · 34% of these records are older, 63% newer
- In a Medicare fileYes · 82% of these records are
- In the CMS Doctors and Clinicians fileYes · 79% of these records are
- Graduated2009 · median 2015 among the 1,926 with a school on file
- Record last updated2023 · 48% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 367500000X and a Illinois practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Certified Registered Nurse Anesthetist providers in Illinois
There are 2,444 certified registered nurse anesthetist records in Illinois.
All 2,444 in Illinois → Every provider in Elgin → Certified Registered Nurse Anesthetist nationwide →
The 8 certified registered nurse anesthetist records with the nearest ZIP codes
- Ruben Dettman, CRNAElgin, IL 601231881266971
- Janine Goodsite, CRNAElgin, IL 601231093763070
- Syed IqbalElgin, IL 601231093351926
- Sheila Murray, CRNAElgin, IL 601231487108312
- Danielle Nakhshin, CRNAElgin, IL 601231942510151
- Pratixa PatelElgin, IL 601231891210647
- James ReddingElgin, IL 601231124403563
- Joan Young, CRNAElgin, IL 601231518925544
Common questions
What is Souphaphone Bounmythavong Nicksic, CRNA's NPI number?
Souphaphone Bounmythavong Nicksic, CRNA's National Provider Identifier (NPI) is 1740425701, issued on Dec 4, 2008. An NPI identifies a provider in billing; it is not a license.
Where is Souphaphone Bounmythavong Nicksic, CRNA located?
The NPPES record lists a practice address at 1425 N Randall RD, Elgin, IL, 60123. Phone: (224) 783-1065. Providers update this record themselves, so call before visiting.
How can I verify Souphaphone Bounmythavong Nicksic, CRNA's license?
NPPES lists Illinois license number 209008677, as entered by the provider. Search the Illinois board that licenses this profession; the NPPES record confirms identity only.
What is Souphaphone Bounmythavong Nicksic, CRNA's MIPS final score?
The 2023 MIPS final score is 99.5 of 100. The average among 454,083 clinicians with a measured score was 83.5.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.