ANGELA K. ANSELM (FNP-BC) – Family Nurse Practitioner, NPI 1679884944
Family Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for ANGELA K. ANSELM (FNP-BC)
1025 S 6TH ST
SPRINGFIELD, IL 627032403
Phone: (217) 528-7541
Fax: (217) 528-8962
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $13.
Total Amount is formed as General ($13) + Research ($0) + Ownership ($0) = $13.
Last reported payment date: 2024-04-24 • Largest payer in this snapshot: Braeburn Inc. ($13).
Total Amount
$13
General + Research + Ownership
Payments
1
Total payment records
General Amount
$13
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Braeburn Inc. | $13 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-11-06
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20101106000057 | I | Nurse Practitioner | IL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 62703)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Emergency Medicine | IL | |
| Nurse Practitioner | IL | |
| Physician Assistant | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
Reviews
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