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ANGELIQUE WILLIS APRN
NPI 1053282129
Nurse Practitioner in Saint Augustine, FL

Active since September 13, 2025PECOS Enrolled
217 ASHBROOK ST, SAINT AUGUSTINE, FL 32084(904) 599-9192 Get Directions Write a Review

NPPES record last updated: September 13, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Angelique Willis Aprn NPPES

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

ANGELIQUE WILLIS APRN (NPI 1053282129) is an individual nurse practitioner in Saint Augustine, Florida, licensed in Florida (APRN11042009) and active in the NPI registry since September 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1053282129
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameANGELIQUE WILLISCredential: APRN
Location Address217 ASHBROOK STSaint Augustine, FL 32084-0086
Mailing Address217 Ashbrook StSaint Augustine, FL 32084-0086
Phone(904) 599-9192
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateSeptember 13, 2025
NPPES CertifiedSeptember 13, 2025
✔ NPI 1053282129 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in FL · APRN11042009
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
217 ASHBROOK ST, Saint Augustine, FL 32084
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Angelique Willis Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3779064357
PECOS Enrollment IDI20260221000689
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 Reassignment

Medicare enrollment records show Angelique Willis reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Ivx Health Of Florida, P.A.
86 mi
Infusion Therapy
293 E ALTAMONTE DR STE 1201
Altamonte Springs, FL 32701
  • Reassigned Medicare billing, Florida enrollment
  • Medicare enrollment name: Ivx Health Of Florida PA
  • 92 clinicians in this Medicare group
NPI 1821622432 (407) 392-3171

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32084 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
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
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.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Angelique Willis's NPI number?

The NPI number for Angelique Willis is 1053282129. It was assigned to this individual provider in the NPPES registry on September 13, 2025.

Where is Angelique Willis located?

Angelique Willis practices at 217 Ashbrook St, Saint Augustine, FL 32084. The listed phone number is (904) 599-9192.

What is Angelique Willis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Angelique Willis enrolled in Medicare?

Yes. Angelique Willis is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Angelique Willis's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Angelique Willis reassigns Medicare benefits to Ivx Health Of Florida, P.A. (Altamonte Springs, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Angelique Willis's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Angelique Willis was last updated on September 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.