JELISA VICK AG-ACNP NPI 1548645021

Nurse Practitioner (Acute Care) in Albuquerque, NM

NPI 1548645021 Individual Female Years of Experience 7 Nurse Practitioner Acute Care PECOS Enrolled Accepts Medicare Approved Payment

About JELISA VICK

Jelisa Vick is a provider established in Albuquerque, New Mexico and her medical specialization is nurse practitioner (acute care) with more than 7 years of experience. The NPI number of Jelisa Vick is 1548645021 and was assigned on July 2015. The practitioner's primary taxonomy code is 363LA2100X with license number CNP-02725 (NM). The provider is registered as an individual and her NPI record was last updated 3 years ago.

A nurse practitioner (NP) like Jelisa Vick Ag-acnp is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

Jelisa Vick is enrolled in PECOS and is eligible to order or refer healthcare services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices

Jelisa Vick is registered with Medicare and accepts claims assignment, this means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or copayment amount for a visit or service. According to Medicare claims data she has hospital affiliations with Flagstaff Medical Center.

NPI

1548645021

Provider Name JELISA VICK AG-ACNP
Provider Location Address2211 LOMAS BLVD NE TRAUMA/SURGICAL INTENSIVE CARE UNIT ALBUQUERQUE, NM 87106
Provider Mailing AddressPO BOX 967 FLAGSTAFF, AZ 86002
GenderFemale
NPI Entity TypeIndividual
Medical School NameOTHER
Graduation Year2015
Is Sole Proprietor?No
Is Organization Subpart?N/A
Enumeration Date07-24-2015
Last Update Date08-27-2018


Primary Taxonomy

Taxonomy Code363LA2100X
ClassificationNurse Practitioner
TypePhysician Assistants & Advanced Practice Nursing Providers
SpecializationAcute Care
License No.CNP-02725
License StateNM

Business Address

JELISA VICK AG-ACNP
2211 LOMAS BLVD NE
TRAUMA/SURGICAL INTENSIVE CARE UNIT
ALBUQUERQUE, NM
ZIP 87106
Phone: (505) 272-2721

Get Directions


Mailing Address

JELISA VICK AG-ACNP
PO BOX 967
FLAGSTAFF, AZ
ZIP 86002
Phone: (928) 773-0003
Fax: (928) 773-1170



Secondary Locations

1200 N Beaver St
Flagstaff, AZ 86001
(928) 773-0003

Medicare Participation

Registered in PECOS? Yes What is PECOS?
PECOS is the Medicare Provider, Enrollment, Chain and Ownership System. PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals. A NPI number is necessary to register in PECOS. Providers must enroll in PECOS to avoid denied claims.
PECOS PAC ID4688983687
PECOS Enrollment IDI20170124001333
Accepts Medicare Assignment? Yes "What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.
Eligible order / refer Part B Clinical Laboratory and ImagingYes
Eligible order / refer Durable Medical EquipmentYes
Eligible order / refer Home Health Agency (HHA)Yes
Eligible order / refer Power Mobility DevicesYes

Hospital Affiliations

Medicare hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the Medicare claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jelisa Vick is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type CMS Certification Number (CCN) Overall Rating
FLAGSTAFF MEDICAL CENTER1200 NORTH BEAVER STREET
FLAGSTAFF, AZ 86001
(928) 779-3366Acute Care Hospitals30023

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
226889MEDICAID (05)AZ

Other Providers at the same location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1902808918DR. MARY S MCKEE MD
Individual
Radiology (Diagnostic Radiology)2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-2269
1740278332 TRACI A MCKINNEY CFNP
Individual
Nurse Practitioner (Family)2211 LOMAS BLVD NE 5TH FLOOR
ALBUQUERQUE, NM 87106
(505) 272-4750
1952392516DR. J. MITCHELL SIMSON MD, MPH
Individual
Internal Medicine (Addiction Medicine)2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-3850
1992786909 MARCY SMITH CNP
Individual
Nurse Practitioner (Adult Health)2211 LOMAS BLVD NE 2ND FLOOR
ALBUQUERQUE, NM 87106
(505) 272-3189
1891766226 DARREN BRAUDE MD
Individual
Emergency Medicine2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-8950
1609848118 MELISSA S ROSEN M.D.
Individual
Family Medicine2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-8950
1639134620 KOH BOAYUE MD
Individual
Internal Medicine (Hematology & Oncology)2211 LOMAS BLVD NE 3RD FLOOR
ALBUQUERQUE, NM 87106
(505) 272-4461
1649228479 JOYCE VAN DELLEN CFNP
Individual
Nurse Practitioner (Occupational Health)2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-2517
1932157351MS. MELODY LOU LAFRINIERE PHD
Individual
Psychologist (Clinical)2211 LOMAS BLVD NE PSY CONSULTATION
ALBUQUERQUE, NM 87106
(505) 272-4763
1770534521DR. REBECCA H MORAN MD
Individual
Pediatrics (Neonatal-Perinatal Medicine)2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-5437
1821037516 JASON QUINCEY MCKEE MD
Individual
Surgery (Pediatric Surgery)2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-5913
1376586925 JON LOVE M.D.
Individual
Pediatrics (Pediatric Cardiology)2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-3864
1407888613MR. JOHN RUSH PIERCE JR. MD
Individual
Internal Medicine2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-2147
1730112392DR. SETH H LOWELL MD
Individual
Otolaryngology2211 LOMAS BLVD NE 2ND FLOOR - SURGICAL SPECIALTY CLINICS
ALBUQUERQUE, NM 87106
(505) 272-6451
1841212347 ROBERT STRICKLAND MD
Individual
Internal Medicine (Gastroenterology)2211 LOMAS BLVD NE 5TH FLOOR
ALBUQUERQUE, NM 87106
(505) 925-6643
1831112762 JOSE A. PADIN-ROSADO MD
Individual
Psychiatry & Neurology (Neurology)2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106
(505) 272-3342
1205841764 NANCY E JOSTE MD
Individual
Pathology (Clinical Pathology/Laboratory Medicine)2211 LOMAS BLVD NE DEPARTMENT OF PATHOLOGY
ALBUQUERQUE, NM 87106
(505) 272-2445
1245245703 KENDALL MUSTON ROGERS MD
Individual
Internal Medicine2211 LOMAS BLVD NE UNM HOSPITAL
ALBUQUERQUE, NM 87106
(505) 272-2111
1053326512 KAY SEDLER CNM
Individual
Advanced Practice Midwife2211 LOMAS BLVD NE AMBULATORY CARE CENTER - 4
ALBUQUERQUE, NM 87106
(505) 272-2245
1043225501 AMY STAPLES MD
Individual
Pediatrics (Pediatric Nephrology)2211 LOMAS BLVD NE 3-ACC
ALBUQUERQUE, NM 87106
(505) 272-2345

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.