AMNE INTISSAR (AGACNP) – Acute Care Nurse Practitioner, NPI 1538846258

AMNE INTISSAR (AGACNP) is a healthcare provider. based in O fallon, Illinois. specializing in Acute Care Nurse Practitioner. They hold the professional credentials AGACNP. They hold a License No. 209027601 (IL). The NPI Number for AMNE INTISSAR (AGACNP) is 1538846258

Main info

Female
Name
AMNE INTISSAR (AGACNP)
NPI
1538846258
Phone
(206) 579-7657
Address
1064 OXFORD HILL RD
Enumeration Date
4 July 2023
Last Update Date
4 July 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:2State licenses:3Digital endpointsOther names

Provider Addresses for AMNE INTISSAR (AGACNP)

  • 1064 OXFORD HILL RD

    O FALLON, IL 622696825

    Phone: (206) 579-7657

    Type: Mailing

  • 241 NORTH RD

    POUGHKEEPSIE, NY 126011154

    Phone: (845) 483-5000

    Type: Location

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: 2023-09-05

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
I20230905003694INurse PractitionerNYTBD

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 62269)

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Reviews

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Frequently asked questions

How is AMNE INTISSAR (AGACNP) identified in CMS data?
CMS-hosted NPPES data lists AMNE INTISSAR (AGACNP) with NPI 1538846258.
Can I rely on AMNE INTISSAR (AGACNP) being an active provider?
As of the registry snapshot, AMNE INTISSAR (AGACNP) is marked active.
What is AMNE INTISSAR (AGACNP)'s specialty?
The listing groups AMNE INTISSAR (AGACNP) with Acute Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for AMNE INTISSAR (AGACNP)?
AMNE INTISSAR (AGACNP)'s geographic hint is O Fallon, Illinois in our summary view.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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