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ANGELIQUE VICTORIA HOLLEY
NPI 1205659174
Physician Assistant in Salem, OR

Active since November 07, 2024PECOS Enrolled
3896 BEVERLY AVE NE STE 40, SALEM, OR 97305(503) 588-0076 Get Directions Write a Review

NPPES record last updated: March 2, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 2, 2026, Nov 7, 2024 (2 updates tracked since 2024).

About Angelique Victoria Holley NPPES

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

ANGELIQUE VICTORIA HOLLEY (NPI 1205659174) is an individual physician assistant in Salem, Oregon, licensed in Oregon (PA228517) and active in the NPI registry since November 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1205659174
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameANGELIQUE VICTORIA HOLLEY
Location Address3896 BEVERLY AVE NE STE 40Salem, OR 97305-1374
Mailing AddressPo Box 190Toppenish, WA 98948-0190 · (509) 865-2395
Phone(503) 588-0076
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 7, 2024
Last NPPES UpdateMarch 2, 20262 updates tracked since enumeration
NPPES CertifiedMarch 2, 2026
✔ NPI 1205659174 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in OR · PA228517
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
3896 BEVERLY AVE NE STE 40, Salem, OR 97305
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

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

PECOS PAC ID244713444
PECOS Enrollment IDI20260316003685
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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97305 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
$84.82 typical visit price
range $54.96 – $166.64
Typical copayment $21.20 (range $13.74 – $41.66)
Most-billed visit code 99203
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
Most-billed visit code 99213
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 6

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

MCKENNA CHANDLER PA-S
Physician Assistant
3896 BEVERLY AVE NE STE 40
SALEM, OR 97305
Marion County (503) 588-0076
CAROLINA REGALADO MURILLO MPH
Physician Assistant
3896 BEVERLY AVE NE STE 40
SALEM, OR 97305
Marion County (503) 588-0076
AMBER NORTHCUTT
Physician Assistant
3896 BEVERLY AVE NE STE 40
SALEM, OR 97305
Marion County (503) 588-0076
ROBERTO CARLOS GUILLEN PA-C
Physician Assistant
3896 BEVERLY AVE NE STE 40
SALEM, OR 97305
Marion County (503) 588-0076
BJAI A RICE DO
Family Medicine
3896 BEVERLY AVE NE STE 40
SALEM, OR 97305
Marion County (503) 588-7578
MRS. ROCIO PETERSEN MS, RDN
Dietitian, Registered
3896 BEVERLY AVE NE STE 40
SALEM, OR 97305
Marion County (503) 588-0076

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 Holley's NPI number?

The NPI number for Angelique Holley is 1205659174. It was assigned to this individual provider in the NPPES registry on November 7, 2024.

Where is Angelique Holley located?

Angelique Holley practices at 3896 Beverly Ave NE Ste 40, Salem, OR 97305. The listed phone number is (503) 588-0076.

What is Angelique Holley's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Angelique Holley enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Angelique Holley was last updated on March 2, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.