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

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 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 Name	Dietra Leigh Angelly
Gender	Female
Speciality	Nurse Practitioner
Experience	6 Years
Location	3411 Professional Park Dr, Marion, Illinois
Accepts Medicare Assignments	Yes. 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.

Identifier	Type	State	Issuer
1902371313	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	209018044 (Illinois)	Secondary
363L00000X	Nurse Practitioner	209018044 (Illinois)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Heartland Regional Medical Center	Marion, IL	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Deaconess Illinois Clinic Inc	5092187021	21

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 Name	Deaconess Illinois Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1962128256 PECOS PAC ID: 5092187021 Enrollment ID: O20230220002667

Entity Name	Deaconess Illinois Specialty Clinic, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI 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 Address	Practice 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
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
Michelle Wharton, APN, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3412 Office Park Dr, Marion, IL 62959 Phone: 618-993-0404

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