MRS. MARLENA DAGOSTIN – Family Nurse Practitioner, NPI 1720578180

MRS. MARLENA DAGOSTIN is a healthcare provider. based in Belvidere, Illinois. specializing in NURSE PRACTITIONER. They hold a License No. RBT-17-45125 (IL). The NPI Number for MRS. MARLENA DAGOSTIN is 1720578180

Main info

Female
Sole Proprietor
2 Years Of Experience
Accepts Medicare Assignment
Name
MRS. MARLENA DAGOSTIN
NPI
1720578180
Phone
Not provided
Address
3588 CROSS CREEK ESTATES LN
Enumeration Date
11 May 2018
Deactivation Date
28 January 2025
Reactivation Date
26 February 2025
Last Update Date
28 February 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8159712000
Graduation Year
2024 (2 years ago)
PAC ID
9436674959
Group Practice PAC ID
2567374036
Professional Enrollment ID
I20250417000742
Address ID
IL611142300RO8201XBLVD400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:8State licenses:2Digital endpointsOther names

11,637 NURSE PRACTITIONER in IL

Provider Addresses for MRS. MARLENA DAGOSTIN

  • 3588 CROSS CREEK ESTATES LN

    BELVIDERE, IL 610089734

    Phone:

    Type: Mailing

  • 5000 PRAIRIE ROSE DR

    ROSCOE, IL 610737792

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-04-17

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250417000742INurse PractitionerILTBD

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.

Verify on CMS Revalidation Lookup Tool

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 61008)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567374036View full group profile

Reviews

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Frequently asked questions

How do payers reference MRS. MARLENA DAGOSTIN?
For MRS. MARLENA DAGOSTIN, use NPI 1720578180 as the unique 10-digit identifier.
Would MRS. MARLENA DAGOSTIN appear as active to a payer?
You can treat MRS. MARLENA DAGOSTIN as active for directory purposes; confirm clinical privileges separately.
What clinical focus is listed for MRS. MARLENA DAGOSTIN?
At a glance, MRS. MARLENA DAGOSTIN is tied to Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with MRS. MARLENA DAGOSTIN?
Directory geography for MRS. MARLENA DAGOSTIN centers on Belvidere, Illinois.
What does 4 location(s) imply?
4 practice locations appear in the available data.

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