Mr Charles Albert Tollett Jr, MD is a medicare enrolled "Surgery" physician in Huntingburg, Indiana. His current practice location is
407 E 22nd St, Huntingburg, Indiana. You can reach out to his office (for appointments etc.) via phone at
(812) 683-6339.
Mr Charles Albert Tollett Jr is licensed to practice in Indiana (license number 01042157) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497827356.
Physician's Profile
| Full Name | Mr Charles Albert Tollett Jr |
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| Gender | Male |
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| Speciality | Surgery |
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| Location | 407 E 22nd St, Huntingburg, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1497827356
- Provider Enumeration Date: 11/15/2006
- Last Update Date: 08/19/2011
Medicare PECOS Information:
- PECOS PAC ID: 3072531417
- Enrollment ID: I20110812000264
Medical Identifiers
Medical identifiers for Mr Charles Albert Tollett Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1497827356 | NPI | - | NPPES |
| 000000238257 | Other | IN | ANTHEM |
| 1004142200 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208600000X | Surgery | 01042157 (Indiana) | 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. Mr Charles Albert Tollett Jr allows following entities to bill medicare on his behalf.
| Entity Name | Little Company Of Mary Hospital Of Indiana Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114120128 PECOS PAC ID: 4587578042 Enrollment ID: O20031118000733 |
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| Entity Name | Little Company Of Mary Hospital Of Indiana Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881843522 PECOS PAC ID: 4587578042 Enrollment ID: O20081211000204 |
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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. Mr Charles Albert Tollett Jr 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 |
Mr Charles Albert Tollett Jr, MD P O Box 327, Huntingburg, IN 47542-0327 Ph: (812) 683-6339 | Mr Charles Albert Tollett Jr, MD 407 E 22nd St, Huntingburg, IN 47542-8964 Ph: (812) 683-6339 |
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