Carly Rae Tepsick, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Poland, Ohio. She graduated from medical school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Triad Health Services Llc and her current practice location is
715 E Western Reserve Rd, Poland, Ohio. You can reach out to her office (for appointments etc.) via phone at
(330) 726-3204.
Carly Rae Tepsick is licensed to practice in Ohio (license number APRN.CNP.0030759) 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 1073268249.
Physician's Profile
Full Name | Carly Rae Tepsick |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Experience | 3 Years |
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Location | 715 E Western Reserve Rd, Poland, Ohio |
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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:
- Carly Rae Tepsick graduated from medical school in 2021
NPI Data:
- NPI Number: 1073268249
- Provider Enumeration Date: 02/16/2022
- Last Update Date: 10/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 9739575077
- Enrollment ID: I20220413001020
Medical Identifiers
Medical identifiers for Carly Rae Tepsick such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073268249 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RC0000X | Internal Medicine - Cardiovascular Disease | APRN.CNP.0030759 (Ohio) | Secondary |
363LF0000X | Nurse Practitioner - Family | APRN.CNP.0030759 (Ohio) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Triad Health Services Llc | 9032367917 | 187 |
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. Carly Rae Tepsick allows following entities to bill medicare on her behalf.
Entity Name | Triad Health Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1588925457 PECOS PAC ID: 9032367917 Enrollment ID: O20120918000787 |
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Entity Name | Mercy Health Physicians Youngstown Specialty Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1649892225 PECOS PAC ID: 3476950296 Enrollment ID: O20210921003835 |
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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. Carly Rae Tepsick 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 |
Carly Rae Tepsick, FNP-C 715 E Western Reserve Rd, Poland, OH 44514-3358 Ph: (330) 726-3204 | Carly Rae Tepsick, FNP-C 715 E Western Reserve Rd, Poland, OH 44514-3358 Ph: (330) 726-3204 |
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