Madelyn Pellicer, APRN

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

11021961 Issued in FL

Practice address

201 Health Park Blvd Ste 105
St Augustine, FL 32086-5770

Phone

(904) 824-1776

Fax

(904) 825-1270

NPI assigned

Oct 5, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Miss Madelyn Elyzabeth Aitken Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

81.78 of 100Reported as apm

Quality

77.66

Promoting interoperability

70.54

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• St Augustine Cardiology Associates PA

  • Cardiovascular Disease Physician
  • St Augustine, FL
  • NPI 1588768147
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664928000000",
    "number": "1114642865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 HEALTH PARK BLVD STE 105",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865770",
            "telephone_number": "904-824-1776",
            "fax_number": "904-825-1270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 HEALTH PARK BLVD STE 105",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865770",
            "telephone_number": "904-824-1776",
            "fax_number": "904-825-1270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLICER",
        "first_name": "MADELYN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2022-10-05",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "11021961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADELYN",
            "last_name": "AITKEN",
            "middle_name": "ELYZABETH",
            "prefix": "MISS",
            "credential": "APRN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Pediatrics of St. Augustine
• Pediatrix Medical Group of Florida, Inc
• Peglar LLC
• Janice Pehr
• Kelsey Pelletreau
• Melba Faye Peludat, MASSAGE THERAPIST
• Jennifer Cecelia Pember, MS
• Pemberley Administrative Services, LLC
• Margaret Pemberton
• Katharine Penny

• Adult Health Nurse Practitioner in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Adult Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.