Souphaphone Bounmythavong Nicksic, CRNA
NPI 1740425701ActiveIndividual· Nurse Anesthetist, Certified Registered· Elgin, IL
Nurse Anesthetist, Certified Registered (CRNA) with Advocate Health and Hospitals Corporation, practicing in Elgin, Illinois. Medicare paid $16,614 for services to 128 patients in 2024. Intercept Pharmaceuticals, Inc. reported $15.22 in payments in 2025, mostly food and beverage. Lists Advocate Sherman Hospital as a hospital affiliation.
Overview
| NPI | 1740425701 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | CRNA |
| Sole proprietor | No |
| NPI issued | Dec 4, 2008 |
| Last updated in NPPES | Aug 30, 2023 |
| Certified by provider | Aug 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Anesthetist, Certified Registered Primary | 367500000X | 209008677 | IL |
| Nurse Anesthetist, Certified Registered | 367500000X | 28181986A | IN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Certified Registered Nurse Anesthetist (CRNA) (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 128 |
|---|---|
| Services billed | 130 across 35 procedure codes |
| Paid by Medicare | $16,614 |
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Certified Registered Nurse Anesthetist (Crna) |
Medical group
- Advocate Health and Hospitals CorporationChicago, IL · 3,118 clinicians
Hospital affiliation
- Advocate Sherman HospitalElgin, IL
Industry payments (Open Payments)
- 2025$15.22 · 1 payment from 1 company
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Intercept Pharmaceuticals, Inc. | $15.22 | 1 |
What the 2025 payments were for
- Food and Beverage$15.22 · 1 payment
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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