Annemarie Christopulos, is a medicare enrolled "Nurse Practitioner - Family" in South Weber, Utah. Her current practice location is
8212 Deer Run Way, South Weber, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 971-1642.
Annemarie Christopulos is licensed to practice in Utah (license number 11096359-4405) 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 1518684448.
Provider's Profile
| Full Name | Annemarie Christopulos |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 8212 Deer Run Way, South Weber, Utah |
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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: 1518684448
- Provider Enumeration Date: 10/21/2022
- Last Update Date: 10/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 4789056664
- Enrollment ID: I20230203000045
Medical Identifiers
Medical identifiers for Annemarie Christopulos such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1518684448 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | 11096359-4405 (Utah) | 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. Annemarie Christopulos allows following entities to bill medicare on her behalf.
| Entity Name | Tanner Memorial Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1447239355 PECOS PAC ID: 4284547985 Enrollment ID: O20031110000132 |
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| Entity Name | Emergency Physicians Integrated Care Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578598199 PECOS PAC ID: 4284548116 Enrollment ID: O20031115000013 |
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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. Annemarie Christopulos 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 |
Annemarie Christopulos, 8212 Deer Run Way, South Weber, UT 84405-7160 Ph: (801) 971-1642 | Annemarie Christopulos, 8212 Deer Run Way, South Weber, UT 84405-7160 Ph: (801) 971-1642 |
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