Dr Patty J Crocker, MD is a medicare enrolled "Emergency Medicine" physician in Peoria, Arizona. Her current practice location is
9069 W Thunderbird Rd, Peoria, Arizona. You can reach out to her office (for appointments etc.) via phone at
(623) 876-2800.
Dr Patty J Crocker is licensed to practice in Arizona (license number 21076) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1831188911.
Physician's Profile
| Full Name | Dr Patty J Crocker |
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| Gender | Female |
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| Speciality | Emergency Medicine |
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| Location | 9069 W Thunderbird Rd, Peoria, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1831188911
- Provider Enumeration Date: 10/20/2005
- Last Update Date: 05/13/2019
Medicare PECOS Information:
- PECOS PAC ID: 9335128826
- Enrollment ID: I20180827003216
Medical Identifiers
Medical identifiers for Dr Patty J Crocker such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831188911 | NPI | - | NPPES |
| 105650902 | Medicaid | TX | |
| 417643 | Medicaid | AZ | |
| J4757 | Other | TX | STATE LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | J4757 (Texas) | Secondary |
| 207P00000X | Emergency Medicine | 21076 (Arizona) | Primary |
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 Patty J Crocker allows following entities to bill medicare on her behalf.
| Entity Name | Cigna Healthcare Of Arizona Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073626404
PECOS PAC ID: 1456263573
Enrollment ID: O20031105000515 |
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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. Dr Patty J Crocker 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 Patty J Crocker, MD
9069 W Thunderbird Rd,
Peoria, AZ 85381
Ph: (623) 876-2800 | Dr Patty J Crocker, MD
9069 W Thunderbird Rd,
Peoria, AZ 85381
Ph: (623) 876-2800 |
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