Dietra Leigh Angelly, FNP-C - Medicare Nurse Practitioner in Marion, IL

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Dietra Leigh Angelly, FNP-C is a medicare enrolled "Nurse Practitioner" in Marion, Illinois. She graduated from nursing school in 2018 and has 6 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Deaconess Illinois Clinic Inc, Deaconess Illinois Specialty Clinic, Inc. and her current practice location is 3411 Professional Park Dr, Marion, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 969-8630.

Dietra Leigh Angelly is licensed to practice in Illinois (license number 209018044) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902371313.

Contact Information

Dietra Leigh Angelly, FNP-C
3411 Professional Park Dr,
Marion, IL 62959-6394
(618) 969-8630
(618) 993-1421

Map and Direction




Provider's Profile

Full NameDietra Leigh Angelly
GenderFemale
SpecialityNurse Practitioner
Experience6 Years
Location3411 Professional Park Dr, Marion, Illinois
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dietra Leigh Angelly graduated from nursing school in 2018
  NPI Data:
  • NPI Number: 1902371313
  • Provider Enumeration Date: 10/11/2018
  • Last Update Date: 04/08/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9931356276
  • Enrollment ID: I20190130001729

Medical Identifiers

Medical identifiers for Dietra Leigh Angelly such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902371313NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 209018044 (Illinois)Secondary
363L00000XNurse Practitioner 209018044 (Illinois)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Heartland Regional Medical CenterMarion, ILHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Deaconess Illinois Clinic Inc509218702119
Deaconess Illinois Specialty Clinic, Inc.983056201681

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. Dietra Leigh Angelly allows following entities to bill medicare on her behalf.
Entity NameHeartland Rural Healthcare Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275166134
PECOS PAC ID: 3072513043
Enrollment ID: O20061226000075
Entity NameDeaconess Illinois Clinic Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962128256
PECOS PAC ID: 5092187021
Enrollment ID: O20230220002667
Entity NameDeaconess Illinois Specialty Clinic, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1972210235
PECOS PAC ID: 9830562016
Enrollment ID: O20230321001688

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. Dietra Leigh Angelly 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 AddressPractice Location Address
Dietra Leigh Angelly, FNP-C
408 Lincoln Dr Ste B,
Herrin, IL 62948-3790

Ph: (618) 351-4980		Dietra Leigh Angelly, FNP-C
3411 Professional Park Dr,
Marion, IL 62959-6394

Ph: (618) 969-8630

Reviews and Comments


Nurse Practitioner Nurses in Marion, IL

Era Louise Mattingly, APN
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 11522 White Pine Ave, Marion, IL 62959
Phone: 618-889-4834    
Jessie Nicole Fox,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 2808 Outer Dr, Marion, IL 62959
Phone: 618-993-3817    
Ms. Peggy Boyd, CNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 3106 Outer Dr, Marion, IL 62959
Phone: 618-997-4332    Fax: 618-997-6205
Donna R Walters, CNM
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 3408 Office Park Dr, Marion, IL 62959
Phone: 618-997-5266    Fax: 618-997-5285
Mika Lynn Johnson, AGACNP-BC
Nurse Practitioner
Medicare: May Accept Medicare Assignments
Practice Location: 3333 W Deyoung St, Marion, IL 62959
Phone: 618-998-7000    
Mrs. Holly Ann Gates, NP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 3111 Williamson County Pkwy, Marion, IL 62959
Phone: 618-519-9200    Fax: 618-985-9155
Rhonda Raye Heatherly, APN, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 106 S Vicksburg St, Marion, IL 62959
Phone: 618-998-1900    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.