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ANGELIQUE MARIE LEIST
NPI 1053828145
Nurse Practitioner - Family in Louisville, KY

Active since January 10, 2018PECOS EnrolledAccepts Medicare Assignment
3103 BRECKENRIDGE LN STE 1, LOUISVILLE, KY 40220(501) 495-5055(502) 495-5057 Get Directions Write a Review

NPPES record last updated: November 27, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Apr 24, 2020, Jun 12, 2019, Jan 18, 2018 and 1 more (4 updates tracked since 2018).

About Angelique Marie Leist NPPES

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

ANGELIQUE MARIE LEIST (NPI 1053828145) is an individual family provider in Louisville, Kentucky, licensed in Kentucky (3012004) and active in the NPI registry since January 2018. She is enrolled in Medicare PECOS, maintains a secondary practice location in Louisville, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1053828145
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameANGELIQUE MARIE LEIST
Location Address3103 BRECKENRIDGE LN STE 1Louisville, KY 40220
Mailing Address3103 Breckenridge Ln Ste 1Louisville, KY 40220-2798 · (501) 495-5055 · Fax (502) 495-5057
Phone(501) 495-5055
Fax(502) 495-5057
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateJanuary 10, 2018
Last NPPES UpdateNovember 27, 20234 updates tracked since enumeration
NPPES CertifiedApril 24, 2020
✔ NPI 1053828145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in KY · 3012004
Also ListedRegistered NurseTaxonomy 163W00000X · License 1146850 (KY)
3103 BRECKENRIDGE LN STE 1, Louisville, KY 40220
Open in Google Maps ↗

Secondary Practice Location 1

Location 11265 Goss AveLouisville, KY 40217-2271 · Phone (502) 873-1260

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.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

Angelique Marie Leist 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 ID8022378405
PECOS Enrollment IDI20180202001012
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

4

Medicare enrollment records show Angelique Leist reassigns Medicare billing to 4 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Gim Of Kentucky PLLC
10 mi
Internal Medicine
16605 CHESTNUT GLEN PL
Louisville, KY 40245
  • Reassigned Medicare billing, Kentucky enrollment
  • 43 clinicians in this Medicare group
NPI 1326411026 (502) 709-0430
Brock Medical, LLC
113 mi
Nurse Practitioner
1752 HIGHWAY 192 W, SUITE 1
London, KY 40741
  • Reassigned Medicare billing, Kentucky enrollment
  • 362 clinicians in this Medicare group
NPI 1023379815 (606) 330-0055
Fast Pace Kentucky PLLC
117 mi
Family
1475 NASHVILLE RD
Franklin, KY 42134
  • Reassigned Medicare billing, Kentucky enrollment
  • 427 clinicians in this Medicare group
NPI 1457716706 (270) 813-1111
Upperline Healthcare, PC
338 mi
Foot & Ankle Surgery
2116 CHAPEL HILL RD
Hoover, AL 35216
  • Reassigned Medicare billing, Kentucky enrollment
  • 270 clinicians in this Medicare group
NPI 1538686498 (407) 219-5402

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 5

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.

Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
73 services36 patients
Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811
This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.
31 services30 patients
Detection test by immunoassay with direct visual observation for streptococcus, group a (strep) 87880
A detection test by immunoassay for Group A Strep is a quick procedure to identify a bacterial infection in your throat. It involves taking a throat swab and applying it to a test strip, which changes color if Strep bacteria are present.
28 services28 patients
Automated urinalysis test 81003
An automated urinalysis test is a routine examination that checks your urine for various substances. It can help identify potential health issues such as kidney problems or diabetes. The test uses a machine to analyze a small urine sample, providing quick and accurate results.
23 services20 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 40220 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
$82.24 typical visit price
range $52.76 – $162.27
Typical copayment $20.56 (range $13.19 – $40.56)
Most-billed visit code 99203
Established Patient
$93.94 typical visit price
range $16.53 – $131.99
Typical copayment $23.48 (range $4.13 – $32.99)
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 Leist's NPI number?

The NPI number for Angelique Leist is 1053828145. It was assigned to this individual provider in the NPPES registry on January 10, 2018.

Where is Angelique Leist located?

Angelique Leist practices at 3103 Breckenridge Ln Ste 1, Louisville, KY 40220. The listed phone number is (501) 495-5055.

What is Angelique Leist's specialty?

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

Is Angelique Leist enrolled in Medicare?

Yes. Angelique Leist is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Angelique Leist's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Angelique Leist reassigns Medicare benefits to 4 organizations: Gim Of Kentucky PLLC (Louisville, KY), Brock Medical, LLC (London, KY), Fast Pace Kentucky PLLC (Franklin, KY) and Upperline Healthcare, PC (Hoover, AL). Each 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 Leist's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Angelique Leist accept?

Health plans from Anthem Blue Cross and Blue Shield list Angelique Leist as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Angelique Leist was last updated on November 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.