Mrs Carla Jo Winter-bryant, APRN is a medicare enrolled "Family Medicine - Adult Medicine" physician in St. Charles, Illinois. Her current practice location is
104 Shoreline Crt, St. Charles, Illinois. You can reach out to her office (for appointments etc.) via phone at
(331) 266-9676.
Mrs Carla Jo Winter-bryant is licensed to practice in Illinois (license number 209.022424) 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 1891996062.
Physician's Profile
| Full Name | Mrs Carla Jo Winter-bryant |
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| Gender | Female |
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| Speciality | Family Medicine - Adult Medicine |
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| Location | 104 Shoreline Crt, St. Charles, Illinois |
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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: 1891996062
- Provider Enumeration Date: 05/29/2007
- Last Update Date: 05/03/2023
Medicare PECOS Information:
- PECOS PAC ID: 0941394704
- Enrollment ID: I20220119000293
Medical Identifiers
Medical identifiers for Mrs Carla Jo Winter-bryant such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1891996062 | NPI | - | NPPES |
| NUR-LIN-LIC 26699 | Other | MT | NURSING LICENSE |
| M011004857 | Other | MT | MEDICARE PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207QA0505X | Family Medicine - Adult Medicine | MT-APRN-100450 (Montana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | NUR-RN-LIC 26699 (Montana) | Secondary |
| 207QA0505X | Family Medicine - Adult Medicine | 209.022424 (Illinois) | 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. Mrs Carla Jo Winter-bryant allows following entities to bill medicare on her behalf.
| Entity Name | Carol Stream Service Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679641823
PECOS PAC ID: 8123055688
Enrollment ID: O20050726000957 |
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| Entity Name | Ngx Illinois Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194438515
PECOS PAC ID: 6901270446
Enrollment ID: O20230323000650 |
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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. Mrs Carla Jo Winter-bryant 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 |
|---|
Mrs Carla Jo Winter-bryant, APRN
104 Shoreline Crt,
St. Charles, IL 60174
Ph: (406) 366-5070 | Mrs Carla Jo Winter-bryant, APRN
104 Shoreline Crt,
St. Charles, IL 60174
Ph: (331) 266-9676 |
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