Colleen Flora Petullo, NP-C in Prescott Valley, AZ

Colleen Flora Petullo, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Prescott Valley, Arizona. Her current practice location is 9695 N. Fiorella St., Prescott Valley, Arizona. You can reach out to her office (for appointments etc.) via phone at (702) 460-9009.

Colleen Flora Petullo is licensed to practice in Arizona (license number RNP227728) 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 1790333003.

Contact Information

	Colleen Flora Petullo, NP-C
	9695 N. Fiorella St., Prescott Valley, AZ 86315
	(702) 460-9009
	Not Available

Map and Direction

Provider's Profile

Full Name	Colleen Flora Petullo
Gender	Female
Speciality	Nurse Practitioner - Family
Location	9695 N. Fiorella St., Prescott Valley, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790333003
Provider Enumeration Date: 08/29/2019
Last Update Date: 12/09/2020

Medicare PECOS Information:

PECOS PAC ID: 4385044890
Enrollment ID: I20210621000593

Medical Identifiers

Medical identifiers for Colleen Flora Petullo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790333003	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	59225 (New Mexico)	Secondary
363LF0000X	Nurse Practitioner - Family	RNP227728 (Arizona)	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. Colleen Flora Petullo allows following entities to bill medicare on her behalf.

Entity Name	Signify Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1689158487 PECOS PAC ID: 3274895263 Enrollment ID: O20210305000869

Entity Name	Lifestyle Wellness Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750016192 PECOS PAC ID: 5092182766 Enrollment ID: O20221109001900

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. Colleen Flora Petullo 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
Colleen Flora Petullo, NP-C 9695 N. Fiorella St., Prescott Valley, AZ 86315 Ph: (928) 312-2030	Colleen Flora Petullo, NP-C 9695 N. Fiorella St., Prescott Valley, AZ 86315 Ph: (702) 460-9009

Reviews and Comments

Nurse Practitioner Nurses in Prescott Valley, AZ

Mrs. Holly Ann Allred, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6386 E Ashton Pl, Prescott Valley, AZ 86314 Phone: 928-533-3971
Reneallia Bennett, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3075 N Windsong Dr Ste A, Prescott Valley, AZ 86314 Phone: 928-350-8780 Fax: 888-674-1228
Cheryl Anne Wagner, ARNP Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 7600 E Florentine Rd, Prescott Valley, AZ 86314 Phone: 928-772-1610
Laura Finkbeiner, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7700 E Florentine Rd Ste 101, Prescott Valley, AZ 86314 Phone: 605-685-3995
Kelly L Marshall, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7700 E Florentine Rd Ste 101, Prescott Valley, AZ 86314 Phone: 928-442-8710 Fax: 928-442-8742
Lindsey M Robbins, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3251 N Windsong Dr, Prescott Valley, AZ 86314 Phone: 928-772-2582
Amy M Thein, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3345 N Windsong Dr, Prescott Valley, AZ 86314 Phone: 928-445-5211

Colleen Flora Petullo, NP-C - Medicare Nurse Practitioner in Prescott Valley, AZ