Katelyn Miranda Deveraux, - Medicare Student in an Organized Health Care Education/Training Program in Pueblo, CO

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Katelyn Miranda Deveraux, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Pueblo, Colorado. 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 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 1386225522.

Contact Information

Katelyn Miranda Deveraux,
902 Lakeview Ave,
Pueblo, CO 81004-3597
(719) 557-5855
Not Available

Map and Direction




Physician's Profile

Full NameKatelyn Miranda Deveraux
GenderFemale
SpecialityStudent In An Organized Health Care Education/training Program
Location902 Lakeview Ave, Pueblo, Colorado
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  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.
IdentifierTypeStateIssuer
1386225522NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine TL.0008870 (Colorado)Secondary
208D00000XGeneral Practice DR.0069707 (Colorado)Secondary
390200000XStudent In An Organized Health Care Education/training Program TL.0008870 (Colorado)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. Katelyn Miranda Deveraux allows following entities to bill medicare on her behalf.
Entity NameIntermountain Medical Group Grand Junction, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI 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 AddressPractice 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



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.