AMOGELANG MARYLIN KEAKOPA ARNP
NPI 1134557333
Nurse Practitioner - Acute Care in Jacksonville, FL

Q: What is Amogelang Keakopa's NPI number?

The NPI number for Amogelang Keakopa is 1134557333. It was assigned to this individual provider in the NPPES registry on October 24, 2013.

Q: What is Amogelang Keakopa's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Amogelang Keakopa was last updated on August 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.

Active since October 24, 2013PECOS Enrolled

100/100

CMS Quality Rating

836 PRUDENTIAL DR STE 1400, JACKSONVILLE, FL 32207(904) 388-6518(904) 384-1005 Get Directions Write a Review

NPPES record last updated: August 7, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Amogelang Marylin Keakopa Arnp NPPES

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

AMOGELANG MARYLIN KEAKOPA ARNP (NPI 1134557333) is an individual acute care provider in Jacksonville, Florida, licensed in Florida (ARNP9243994) and active in the NPI registry since October 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1134557333

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameAMOGELANG MARYLIN KEAKOPACredential: ARNP

Location Address836 PRUDENTIAL DR STE 1400Jacksonville, FL 32207-8340

Mailing AddressPo Box 746647Atlanta, GA 30374-6647 · (904) 202-2092 · Fax (904) 384-1005

Phone(904) 388-6518

Fax(904) 384-1005

Sole ProprietorNo

Enumeration DateOctober 24, 2013

Last NPPES UpdateAugust 7, 2025

NPPES CertifiedAugust 7, 2025

✔ NPI 1134557333 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in FL · ARNP9243994

836 PRUDENTIAL DR STE 1400, Jacksonville, FL 32207

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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)

Amogelang Marylin Keakopa Arnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Amogelang Keakopa reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Lyerly Baptist Inc

0.6 mi

Neurological Surgery

1650 PRUDENTIAL DR STE 200
Jacksonville, FL 32207

Reassigned Medicare billing, Florida enrollment
71 clinicians in this Medicare group

NPI 1851347801 (904) 388-6518

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 32207 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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 20

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

JESSICA DEFAZIO PA-C

Physician Assistant