Angelique M Stake, ARNP is a medicare enrolled "Family Medicine" in Tampa, Florida. Her current practice location is
3978 W Hillsborough Ave Unit 21b, Tampa, Florida. You can reach out to her office (for appointments etc.) via phone at
(813) 906-1412.
Angelique M Stake is licensed to practice in Florida (license number APRN9214698) 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 1902115165.
Provider's Profile
| Full Name | Angelique M Stake |
|---|
| Gender | Female |
|---|
| Speciality | Family Medicine |
|---|
| Location | 3978 W Hillsborough Ave Unit 21b, Tampa, Florida |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1902115165
- Provider Enumeration Date: 10/05/2010
- Last Update Date: 03/10/2021
Medicare PECOS Information:
- PECOS PAC ID: 9234446642
- Enrollment ID: I20190624001686
Medical Identifiers
Medical identifiers for Angelique M Stake such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902115165 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LP0200X | Nurse Practitioner - Pediatrics | ARNP9214698 (Florida) | Secondary |
| 207Q00000X | Family Medicine | APRN9214698 (Florida) | 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. Angelique M Stake allows following entities to bill medicare on her behalf.
| Entity Name | Access Medical Group Of Tampa Ii, Llc. |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1841700697
PECOS PAC ID: 3274870084
Enrollment ID: O20190131001663 |
|---|
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. Angelique M Stake 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 |
|---|
Angelique M Stake, ARNP
6100 Blue Lagoon Dr Ste 365,
Miami, FL 33126-7010
Ph: (786) 322-7333 | Angelique M Stake, ARNP
3978 W Hillsborough Ave Unit 21b,
Tampa, FL 33614-5628
Ph: (813) 906-1412 |
Reviews and Comments