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AILISSA TEKLA RETALIC APRN
NPI 1417847492
Nurse Practitioner - Psychiatric/Mental Health in Debary, FL

Active since July 09, 2025PECOS Enrolled
110 POND CT STE 201, DEBARY, FL 32713(386) 317-8635 Get Directions Write a Review

NPPES record last updated: December 9, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 9, 2025, Jul 9, 2025 (2 updates tracked since 2025).

About Ailissa Tekla Retalic Aprn NPPES

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

AILISSA TEKLA RETALIC APRN (NPI 1417847492) is an individual psychiatric/mental health provider in Debary, Florida, licensed in Florida (11040778) and active in the NPI registry since July 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1417847492
Entity TypeIndividualFemale
Primary Taxonomy363LP0808X
Provider Legal NameAILISSA TEKLA RETALICCredential: APRN
Location Address110 POND CT STE 201Debary, FL 32713-2717
Mailing Address1826 Whippoorwill LnDeland, FL 32720-2103 · (386) 490-7537 · Fax (386) 490-7537
Phone(386) 317-8635
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateJuly 9, 2025
Last NPPES UpdateDecember 9, 20252 updates tracked since enumeration
NPPES CertifiedDecember 9, 2025
✔ NPI 1417847492 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in FL · 11040778
110 POND CT STE 201, Debary, FL 32713
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Health Care Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ailissa Tekla Retalic Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID143708610
PECOS Enrollment IDI20260128000352
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 Ailissa Retalic reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Florida Health Care Plan, Inc
24 mi
Preferred Provider Organization
2450 MASON AVE
Daytona Beach, FL 32114
  • Reassigned Medicare billing, Florida enrollment
  • 132 clinicians in this Medicare group
NPI 1558302042 (386) 615-4021

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 32713 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.

Other Providers at the Same Location NPPES

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

LISA DANTE LMHC
Counselor (Mental Health)
110 POND CT STE 201
DEBARY, FL 32713
Volusia County (386) 252-7119

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 Ailissa Retalic's NPI number?

The NPI number for Ailissa Retalic is 1417847492. It was assigned to this individual provider in the NPPES registry on July 9, 2025.

Where is Ailissa Retalic located?

Ailissa Retalic practices at 110 Pond Ct Ste 201, Debary, FL 32713. The listed phone number is (386) 317-8635.

What is Ailissa Retalic's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Ailissa Retalic enrolled in Medicare?

Yes. Ailissa Retalic is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Ailissa Retalic's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Ailissa Retalic reassigns Medicare benefits to Florida Health Care Plan, Inc (Daytona Beach, 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 Ailissa Retalic's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Ailissa Retalic accept?

Health plans from Florida Health Care Plans list Ailissa Retalic 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 Ailissa Retalic was last updated on December 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.