Katelyn Miranda Deveraux, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Pueblo, Colorado. She graduated from medical school in 2020 and has 6 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Intermountain Medical Group Grand Junction, Llc and her current practice location is
902 Lakeview Ave, Pueblo, Colorado. You can reach out to her office (for appointments etc.) via phone at
(719) 557-5855.
Katelyn Miranda Deveraux is licensed to practice in Colorado (license number TL.0008870) 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 1386225522.
Physician's Profile
| Full Name | Katelyn Miranda Deveraux |
|---|
| Gender | Female |
|---|
| Speciality | Family Practice |
|---|
| Experience | 6 Years |
|---|
| Location | 902 Lakeview Ave, Pueblo, Colorado |
|---|
| 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:
- Katelyn Miranda Deveraux graduated from medical school in 2020
NPI Data:
- NPI Number: 1386225522
- Provider Enumeration Date: 04/19/2021
- Last Update Date: 04/17/2023
Medicare PECOS Information:
- PECOS PAC ID: 7113328105
- Enrollment ID: I20250421000805
Medical Identifiers
Medical identifiers for Katelyn Miranda Deveraux such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386225522 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | TL.0008870 (Colorado) | Secondary |
| 208D00000X | General Practice | DR.0069707 (Colorado) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | TL.0008870 (Colorado) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Intermountain Medical Group Grand Junction, Llc | 3779707856 | 245 |
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. Katelyn Miranda Deveraux allows following entities to bill medicare on her behalf.
| Entity Name | Intermountain Medical Group Grand Junction, Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1356765556
PECOS PAC ID: 3779707856
Enrollment ID: O20140611000363 |
|---|
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. Katelyn Miranda Deveraux 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 |
|---|
Katelyn Miranda Deveraux,
902 Lakeview Ave,
Pueblo, CO 81004-3597
Ph: () - | Katelyn Miranda Deveraux,
902 Lakeview Ave,
Pueblo, CO 81004-3597
Ph: (719) 557-5855 |
Reviews and Comments