Noelle Appel
Nurse Anesthetist, Certified Registered · Waco, TXNPI 1184082075
Payments from drug & device makers
Across 26 payments — averaging $29.34 each. Meals, travel, consulting and speaking fees, gifts and royalties reported by drug and device makers.
- Medtronic$238
- Boston Scientific$140
- Biodelivery Sciences International, Inc.$121
- Salix Pharmaceuticals, A Division Of Bausch Health US, LLC$88
- Averitas Pharma Inc.$58
- Painteq LLC$39
- plus $78 from 4 others
What the payments were for
- Food & beverage$763100%
Most of this is food and beverage — typically meals provided during product presentations at a clinic or hospital. Nationally that is the single largest category of reported payments by count.
General payments by program year
Who reported the general payments
Companies are grouped under their corporate parent — a single manufacturer often files under several CMS reporting entities. Research and ownership payments are counted separately and are not in this table.
| Company | Payments | Total |
|---|---|---|
| Medtronic | 5 | $238 |
| Boston Scientific | 7 | $140 |
| Biodelivery Sciences International, Inc. | 2 | $121 |
| Salix Pharmaceuticals, A Division Of Bausch Health US, LLC | 5 | $88 |
| Averitas Pharma Inc. | 2 | $58 |
| Painteq LLC | 1 | $39 |
| Hikma Pharmaceuticals USA | 1 | $25 |
| Pacira Pharmaceuticals Incorporated | 1 | $21 |
| Vertex | 1 | $20 |
| Collegium Pharmaceutical, Inc. | 1 | $13 |
What the payments were tied to
Products named in the reported payments. Only payments of $100 or more are attributed here — the typical reported payment nationally is a meal worth about $16, and listing those product-by-product would be noise.
How this compares
$763 in reported general payments places this provider in the 90th percentile of 4,115 nurse anesthetist, certified registered providers in Texas.
See all nurse anesthetist, certified registered providers in Texas →
Medicare billing
What this is not: this is the amount Original Medicare Part B allowed for services this provider billed in 2024. It is not their income. It excludes Medicare Advantage — now more than half of all Medicare enrollment — along with Medicaid and all commercial insurance, and it is gross practice revenue before staff, rent, supplies and malpractice premiums. CMS also suppresses any figure covering ten or fewer patients, so low-volume providers appear smaller than they are.
Other nurse anesthetist, certified registered in Waco
- Monica LopezDallas$701K
- Jonathan RiddleFort Worth$162K
- Gregory CollinsGranbury$48K
- Amy RobbinsDallas$31K
- Siavosh SaateeDallas$14K
- Douglas MasseySan Antonio$11K
- Stephen LeeDallas$10K
- Melanie AtkinsonDallas$8K
- Donna GoeckeTemple$8K
- Clinton YorkHarlingen$7K
Where these figures come from
- Payments: CMS Open Payments, program years 2019–2025 (publication P06302026_06032026).
- Billing: Medicare Physician & Other Practitioners, data year 2024. Original Medicare Part B only.
- Identity: NPPES NPI Registry, July 2026.