ALEXANDRIA PEBBLES VICENCIO FNP-BC
NPI 1043083587
Nurse Practitioner - Family in Rockford, IL

Q: What is Alexandria Vicencio's NPI number?

The NPI number for Alexandria Vicencio is 1043083587. It was assigned to this individual provider in the NPPES registry on November 6, 2023.

Q: What is Alexandria Vicencio's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Active since November 06, 2023PECOS EnrolledAccepts Medicare Assignment

4215 NEWBURG RD, ROCKFORD, IL 61108(815) 988-8500(815) 977-5956 Get Directions Write a Review

NPPES record last updated: November 6, 2023. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Alexandria Pebbles Vicencio Fnp-bc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALEXANDRIA PEBBLES VICENCIO FNP-BC (NPI 1043083587) is an individual family provider in Rockford, Illinois, licensed in Illinois (209.028650) and active in the NPI registry since November 2023. She is enrolled in Medicare PECOS, is affiliated with Katherine Shaw Bethea Hospital, and is a graduate of Other (2023).

NPPES Registry Identity

NPI1043083587

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameALEXANDRIA PEBBLES VICENCIOCredential: FNP-BC

Location Address4215 NEWBURG RDRockford, IL 61108-6479

Mailing Address4215 Newburg RdRockford, IL 61108-6479 · (815) 988-8500 · Fax (815) 977-5956

Phone(815) 988-8500

Fax(815) 977-5956

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateNovember 6, 2023

NPPES CertifiedNovember 6, 2023

✔ NPI 1043083587 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209.028650

4215 NEWBURG RD, Rockford, IL 61108

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Alexandria Pebbles Vicencio Fnp-bc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID547619629

PECOS Enrollment IDI20231214002181

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Alexandria Vicencio reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

In Home Medical Group LLC

Same address

Family

4215 NEWBURG RD
Rockford, IL 61108

Reassigned Medicare billing, Illinois enrollment
38 clinicians in this Medicare group

NPI 1497087175 (815) 988-8500

Community Home Physicians, LLC

61 mi

Physical Medicine & Rehabilitation

1S450 SUMMIT AVE STE 165
Oakbrook Terrace, IL 60181

Reassigned Medicare billing, Illinois enrollment
97 clinicians in this Medicare group

NPI 1568909505 (630) 320-6871

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 6

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.

676 services220 patients

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309

511 services111 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.

273 services147 patients

Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310

223 services118 patients

Residence visit for established patient with high level of medical decision making, per day, if using time, at least 60 minutes 99350

An established patient home visit is a service where a healthcare professional visits a patient's home for a check-up or treatment. The visit typically lasts for about an hour. This service is especially beneficial for patients who may have difficulty traveling to a healthcare facility.

46 services39 patients

Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, 20 minutes or more 99308

A follow-up nursing facility visit per day is a daily check-up service provided by healthcare professionals. It lasts around 15 minutes and involves assessing your health status, monitoring your recovery progress, and addressing any concerns you may have about your health or treatment.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Katherine Shaw Bethea Hospital

Acute Care Hospitals · Dixon, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140012

Location403 E 1st StDixon, IL 61021 · Lee County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61108 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. STACY GHIGLIERI APRN, FNP-BC

Nurse Practitioner (Family)