Ann Elizabeth Dettlaff, APNP in Appleton, WI - Medicare Nurse Practitioner

Ann Elizabeth Dettlaff, APNP is a medicare enrolled "Nurse Practitioner" in Appleton, Wisconsin. Her current practice location is 720 W. Association Dr., Appleton, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 731-4354.

Ann Elizabeth Dettlaff is licensed to practice in Wisconsin (license number 4360-033) 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 1215236278.

Contact Information

	Ann Elizabeth Dettlaff, APNP
	720 W. Association Dr., Appleton, WI 54914
	(920) 731-4354
	(920) 731-5021

Map and Direction

Provider's Profile

Full Name	Ann Elizabeth Dettlaff
Gender	Female
Speciality	Nurse Practitioner
Location	720 W. Association Dr., Appleton, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215236278
Provider Enumeration Date: 03/16/2011
Last Update Date: 01/09/2024

Medicare PECOS Information:

PECOS PAC ID: 2264618131
Enrollment ID: I20110511000437

Medical Identifiers

Medical identifiers for Ann Elizabeth Dettlaff such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215236278	NPI	-	NPPES
100014463	Medicaid	WI
1215236278	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	4360-33 (Wisconsin)	Secondary
363L00000X	Nurse Practitioner	4360-033 (Wisconsin)	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. Ann Elizabeth Dettlaff allows following entities to bill medicare on her behalf.

Entity Name	Thedacare Medical Center - Wild Rose, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043263999 PECOS PAC ID: 6507840923 Enrollment ID: O20040615000235

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. Ann Elizabeth Dettlaff 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
Ann Elizabeth Dettlaff, APNP 720 W. Association Dr., Appleton, WI 54914 Ph: (920) 731-4354	Ann Elizabeth Dettlaff, APNP 720 W. Association Dr., Appleton, WI 54914 Ph: (920) 731-4354

Reviews and Comments

Nurse Practitioner Nurses in Appleton, WI

Ann M Hefter, AGACNP-BC, MSN, BSN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-731-8900
Kailie Beck, ANPN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1531 S Madison St, Appleton, WI 54915 Phone: 920-738-2000
Dessia J Laxton, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-731-8900 Fax: 920-738-5369
Katie Geiser, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5045 W Grande Market Dr, Appleton, WI 54913 Phone: 920-886-9380
Ingrid K Simpson, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2400 E Capitol Dr, Appleton, WI 54911 Phone: 920-831-5050 Fax: 920-831-1867
Lisa Valiquette, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2500 E Capitol Dr, Appleton, WI 54911 Phone: 920-738-4600 Fax: 920-738-4792
Kimberly A Romenesko, APNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 N Meade St, Appleton, WI 54911 Phone: 920-735-7645 Fax: 920-735-7618

Ann Elizabeth Dettlaff, APNP - Medicare Nurse Practitioner in Appleton, WI