MS. NICOLE ASHLEY POLBOS APRN
NPI 1174063127
Nurse Practitioner in Jacksonville, FL
About Ms. Nicole Ashley Polbos Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. NICOLE ASHLEY POLBOS APRN (NPI 1174063127) is an individual nurse practitioner in Jacksonville, Florida, licensed in Florida (APRN9265534) and active in the NPI registry since February 2017. She is enrolled in Medicare PECOS, is affiliated with Hca Florida North Florida Hospital, and is a graduate of Other (2016).
NPPES Registry Identity
Specialties & Licenses 2
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
Ms. Nicole Ashley Polbos Aprn 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.
Medicare Billing Reassignments
2Medicare enrollment records show Nicole Polbos reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Lake City, FL 32025
- Reassigned Medicare billing, Florida enrollment
- 6 clinicians in this Medicare group
Gainesville, FL 32605
- Reassigned Medicare billing, Florida enrollment
- 46 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Hca Florida North Florida Hospital
Acute Care Hospitals · Gainesville, FLPhysician 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.
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.
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
JACKSONVILLE, FL 32207
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 Nicole Polbos's NPI number?
The NPI number for Nicole Polbos is 1174063127. It was assigned to this individual provider in the NPPES registry on February 24, 2017.
Where is Nicole Polbos located?
Nicole Polbos practices at 836 Prudential Dr Ste 1400, Jacksonville, FL 32207. The listed phone number is (904) 388-6518.
What is Nicole Polbos's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Nicole Polbos enrolled in Medicare?
Yes. Nicole Polbos 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 Nicole Polbos's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Nicole Polbos reassigns Medicare benefits to 2 organizations: Mohammad Ali Faisal, M.D., P.A. (Lake City, FL) and Digestive Disease Associates (Gainesville, FL). 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 Nicole Polbos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Nicole Polbos affiliated with any hospitals?
According to CMS data, Nicole Polbos is affiliated with Hca Florida North Florida Hospital.
When was this NPI record last updated?
The NPPES record for Nicole Polbos was last updated on October 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 days 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.
# Ms. Nicole Ashley Polbos, APRN · NPI 1174063127
Nurse Practitioner physician in Jacksonville, Florida. Individual provider, active in the CMS NPPES registry since February 24, 2017.
## Identity
- **NPI:** 1174063127 (Entity type: Individual)
- **Enumerated:** February 24, 2017
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** APRN9265534 (Florida)
- **Sole proprietor:** No
## Practice location
- **Address:** 836 PRUDENTIAL DR STE 1400, Jacksonville, FL 32207-8340
- **Phone:** (904) 388-6518 · **Fax:** (904) 384-1005
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Mohammad Ali Faisal, M.D., P.A. (NPI 1689639353, Lake City, FL); Digestive Disease Associates (NPI 1083790265, Gainesville, FL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2016
## Record status
- **NPPES last updated:** October 8, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1174063127) · Data from the CMS NPPES public registry.