KAYLISA JANE PEGUERO NP
NPI 1679387666
Nurse Practitioner - Family in Atlanta, GA

Q: What is Kaylisa Peguero's NPI number?

The NPI number for Kaylisa Peguero is 1679387666. It was assigned to this individual provider in the NPPES registry on February 3, 2025.

Q: What is Kaylisa Peguero's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Kaylisa Peguero was last updated on October 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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 February 03, 2025PECOS EnrolledAccepts Medicare Assignment

550 PEACHTREE ST NE, ATLANTA, GA 30308(770) 334-1714 Get Directions Write a Review

NPPES record last updated: October 24, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kaylisa Jane Peguero Np NPPES

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

KAYLISA JANE PEGUERO NP (NPI 1679387666) is an individual family provider in Atlanta, Georgia, licensed in Georgia (RN323827) and active in the NPI registry since February 2025. She is enrolled in Medicare PECOS and is a graduate of Emory University School Of Medicine (2024).

NPPES Registry Identity

NPI1679387666

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameKAYLISA JANE PEGUEROCredential: NP

Location Address550 PEACHTREE ST NEAtlanta, GA 30308-2212

Mailing Address550 Peachtree St NeAtlanta, GA 30308-2212

Phone(770) 334-1714

Sole ProprietorNo

Medical School CMSEmory University School Of MedicineGraduated 2024

Enumeration DateFebruary 3, 2025

Last NPPES UpdateOctober 24, 2025

NPPES CertifiedOctober 24, 2025

✔ NPI 1679387666 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in GA · RN323827

Also ListedNurse PractitionerTaxonomy 363L00000X · License APRN-NP323827 (GA)

550 PEACHTREE ST NE, Atlanta, GA 30308

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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 and accepts Medicare assignment

Kaylisa Jane Peguero Np 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.

PECOS PAC ID3678099959

PECOS Enrollment IDI20250429003449

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 30308 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

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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 20

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

DR. DOMINIC JOSEPH PAPANDRIA M.D.

Surgery