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

Dr Amanda Jean Pettibone-pond, MD is a medicare enrolled "Urology" physician in Bloomington, Indiana. She graduated from medical school in 2011 and has 13 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 Name	Dr Amanda Jean Pettibone-pond
Gender	Female
Speciality	Urology
Experience	13 Years
Location	1520 S Liberty Dr, Bloomington, Indiana
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:

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.

Identifier	Type	State	Issuer
1790075596	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208800000X	Urology	01076608A (Indiana)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
The Outer Banks Hospital, Inc	Nags head, NC	Hospital
Sentara Norfolk General Hospital	Norfolk, VA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Outer Banks Professional Services, Llc	3173652096	80

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 Name	Vidant Medical Group Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477648731 PECOS PAC ID: 0345343893 Enrollment ID: O20070321000445

Entity Name	Outer Banks Professional Services, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI 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 Address	Practice 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: Accepting Medicare Assignments 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

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