Dr Amanda Jean Pettibone-pond, MD - Medicare Urology in Bloomington, IN

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Dr Amanda Jean Pettibone-pond, MD is a medicare enrolled "Urology" physician in Bloomington, Indiana. She graduated from medical school in 2011 and has 15 years of diverse experience with area of expertise as Urology. She is a member of the group practice Outer Banks Professional Services, Llc and her current practice location is 1520 S Liberty Dr, Bloomington, Indiana. You can reach out to her office (for appointments etc.) via phone at (812) 676-4500.

Dr Amanda Jean Pettibone-pond is licensed to practice in Indiana (license number 01076608A) 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 1790075596.

Contact Information

Dr Amanda Jean Pettibone-pond, MD
1520 S Liberty Dr,
Bloomington, IN 47403-5167
(812) 676-4500
(812) 676-4501

Map and Direction




Physician's Profile

Full NameDr Amanda Jean Pettibone-pond
GenderFemale
SpecialityUrology
Experience15 Years
Location1520 S Liberty Dr, Bloomington, Indiana
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Amanda Jean Pettibone-pond graduated from medical school in 2011
  NPI Data:
  • NPI Number: 1790075596
  • Provider Enumeration Date: 04/13/2011
  • Last Update Date: 07/06/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 8628214293
  • Enrollment ID: I20200514002295

Medical Identifiers

Medical identifiers for Dr Amanda Jean Pettibone-pond such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790075596NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208800000XUrology 01076608A (Indiana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
The Outer Banks Hospital, IncNags head, NCHospital
Chesapeake Regional Medical CenterChesapeake, VAHospital
Sentara Albemarle Medical CenterElizabeth city, NCHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Outer Banks Professional Services, Llc3173652096120

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. Dr Amanda Jean Pettibone-pond allows following entities to bill medicare on her behalf.
Entity NameVidant Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477648731
PECOS PAC ID: 0345343893
Enrollment ID: O20070321000445
Entity NameOuter Banks Professional Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891050357
PECOS PAC ID: 3173652096
Enrollment ID: O20100602000156

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. Dr Amanda Jean Pettibone-pond 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 AddressPractice Location Address
Dr Amanda Jean Pettibone-pond, MD
1520 S Liberty Dr,
Bloomington, IN 47403-5167

Ph: (812) 353-3087		Dr Amanda Jean Pettibone-pond, MD
1520 S Liberty Dr,
Bloomington, IN 47403-5167

Ph: (812) 676-4500

Reviews and Comments


Urology Doctors in Bloomington, IN

Dr. Dean L Lenz, M.D.
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1520 S Liberty Dr, Bloomington, IN 47403
Phone: 812-676-4300    Fax: 812-676-4301
Bryan D Hoff, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1302 S Rogers St, Bloomington, IN 47403
Phone: 812-353-3996    Fax: 812-353-5859
Brian J Logue, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 2907 S Mcintire Dr, Bloomington, IN 47403
Phone: 812-332-8765    Fax: 812-336-3425
Paula J Bunde, M.D.
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1520 S Liberty Dr, Bloomington, IN 47403
Phone: 812-676-4500    Fax: 812-676-4501
Mr. Eric M Smith, M.D.
Urology
Medicare: Medicare Enrolled
Practice Location: 2907 S Mcintire Dr, Bloomington, IN 47403
Phone: 812-332-8765    Fax: 812-336-3425
Ashley Shumate, MD
Urology
Medicare: Accepting Medicare Assignments
Practice Location: 1520 S Liberty Dr, Bloomington, IN 47403
Phone: 812-676-4300    
Gregory T Walker, MD
Urology
Medicare: Not Enrolled in Medicare
Practice Location: 1520 S Liberty Dr, Bloomington, IN 47403
Phone: 812-676-4300    Fax: 812-676-4301

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.