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ANDRILYN NEDEDOG NP
NPI 1952811366
Nurse Practitioner - Gerontology in Lake Villa, IL

Active since October 11, 2017PECOS Enrolled
308 APPLETON LN, LAKE VILLA, IL 60046(224) 330-7751 Get Directions Write a Review

NPPES record last updated: October 17, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Andrilyn Nededog Np NPPES

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

ANDRILYN NEDEDOG NP (NPI 1952811366) is an individual gerontology provider in Lake Villa, Illinois, licensed in Illinois (209.016674) and active in the NPI registry since October 2017. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1952811366
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameANDRILYN NEDEDOGCredential: NP
Location Address308 APPLETON LNLake Villa, IL 60046-6405
Mailing Address308 Appleton LnLake Villa, IL 60046-6405 · (224) 330-7751
Phone(224) 330-7751
Sole ProprietorYes
Enumeration DateOctober 11, 2017
Last NPPES UpdateOctober 17, 2017
✔ NPI 1952811366 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in IL · 209.016674
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 209.016674 (IL)
308 APPLETON LN, Lake Villa, IL 60046
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrilyn Nededog Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Andrilyn Nededog reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Prowellness Healthcare Inc.
1,692 mi
Internal Medicine
8439 WHITE OAK AVE STE 1038439
Rancho Cucamonga, CA 91730
  • Reassigned Medicare billing, California enrollment
  • 25 clinicians in this Medicare group
NPI 1053150698 (818) 532-2222

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 60046 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
$93.02 typical visit price
range $59.81 – $181.38
Typical copayment $23.25 (range $14.95 – $45.34)
Most-billed visit code 99203
Established Patient
$105.07 typical visit price
range $19.15 – $147.12
Typical copayment $26.26 (range $4.78 – $36.78)
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.

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 Andrilyn Nededog's NPI number?

The NPI number for Andrilyn Nededog is 1952811366. It was assigned to this individual provider in the NPPES registry on October 11, 2017.

Where is Andrilyn Nededog located?

Andrilyn Nededog practices at 308 Appleton Ln, Lake Villa, IL 60046. The listed phone number is (224) 330-7751.

What is Andrilyn Nededog's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Andrilyn Nededog enrolled in Medicare?

Yes. Andrilyn Nededog is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Andrilyn Nededog's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrilyn Nededog reassigns Medicare benefits to Prowellness Healthcare Inc. (Rancho Cucamonga, CA). 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 Andrilyn Nededog's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Andrilyn Nededog was last updated on October 17, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years 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.