Alexandria Pebbles Vicencio, FNP-BC in Rockford, IL

Alexandria Pebbles Vicencio, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Rockford, Illinois. Her current practice location is 4215 Newburg Rd, Rockford, Illinois. You can reach out to her office (for appointments etc.) via phone at (815) 988-8500.

Alexandria Pebbles Vicencio is licensed to practice in Illinois (license number 209.028650) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043083587.

Contact Information

	Alexandria Pebbles Vicencio, FNP-BC
	4215 Newburg Rd, Rockford, IL 61108-6479
	(815) 988-8500
	(815) 977-5956

Map and Direction

Provider's Profile

Full Name	Alexandria Pebbles Vicencio
Gender	Female
Speciality	Nurse Practitioner - Family
Location	4215 Newburg Rd, Rockford, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043083587
Provider Enumeration Date: 11/06/2023
Last Update Date: 11/06/2023

Medicare PECOS Information:

PECOS PAC ID: 0547619629
Enrollment ID: I20231214002181

Medical Identifiers

Medical identifiers for Alexandria Pebbles Vicencio such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043083587	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	209.028650 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Alexandria Pebbles Vicencio allows following entities to bill medicare on her behalf.

Entity Name	In Home Medical Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497087175 PECOS PAC ID: 3779612395 Enrollment ID: O20100520000116

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alexandria Pebbles Vicencio is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Alexandria Pebbles Vicencio, FNP-BC 4215 Newburg Rd, Rockford, IL 61108-6479 Ph: (815) 988-8500	Alexandria Pebbles Vicencio, FNP-BC 4215 Newburg Rd, Rockford, IL 61108-6479 Ph: (815) 988-8500

Reviews and Comments

Nurse Practitioner Nurses in Rockford, IL

Misty Lynn Dehaven, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1639 N Alpine Rd Ste 260, Rockford, IL 61107 Phone: 815-395-1500 Fax: 815-395-1415
Candice Vicencio, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1235 N Mulford Rd Ste 222, Rockford, IL 61107 Phone: 815-397-8400
Caryn Ann Ruzic, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1600 Fax: 815-490-1881
Tyler James Rafferty, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5666 E State St, Rockford, IL 61108 Phone: 815-226-2000
Angela Giardono, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5666 E State St, Rockford, IL 61108 Phone: 815-226-2000
Melissa L. Inman, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 461 N Mulford Rd Ste 3, Rockford, IL 61107 Phone: 815-227-9594 Fax: 815-227-9574
Michelle L Bennett, APRN Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 3505 N Bell School Rd, Rockford, IL 61114 Phone: 779-696-0300 Fax: 815-639-9433

Alexandria Pebbles Vicencio, FNP-BC - Medicare Nurse Practitioner in Rockford, IL