Elizabeth Mathew Pullukala, in Jacksonville, FL

Elizabeth Mathew Pullukala, is a medicare enrolled "Nurse Practitioner" in Jacksonville, Florida. Her current practice location is 2098 Knottingham Trace Ln, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 525-3684.

Elizabeth Mathew Pullukala is licensed to practice in Florida (license number 11025870) 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 1174305742.

Contact Information

	Elizabeth Mathew Pullukala,
	2098 Knottingham Trace Ln, Jacksonville, FL 32246-1396
	(904) 525-3684
	Not Available

Map and Direction

Provider's Profile

Full Name	Elizabeth Mathew Pullukala
Gender	Female
Speciality	Nurse Practitioner
Location	2098 Knottingham Trace Ln, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174305742
Provider Enumeration Date: 10/18/2023
Last Update Date: 04/15/2025

Medicare PECOS Information:

PECOS PAC ID: 4082158613
Enrollment ID: I20240706000328

Medical Identifiers

Medical identifiers for Elizabeth Mathew Pullukala such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174305742	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	11025870 (Florida)	Primary
208M00000X	Hospitalist	APRN25870 (Florida)	Secondary

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. Elizabeth Mathew Pullukala allows following entities to bill medicare on her behalf.

Entity Name	First Coast Surgical Associates Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548249543 PECOS PAC ID: 5395779359 Enrollment ID: O20070109000450

Entity Name	San Jose Clinic, P.a.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083846349 PECOS PAC ID: 3577606664 Enrollment ID: O20100212000030

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. Elizabeth Mathew Pullukala 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
Elizabeth Mathew Pullukala, 2098 Knottingham Trace Ln, Jacksonville, FL 32246-1396 Ph: (904) 525-3684	Elizabeth Mathew Pullukala, 2098 Knottingham Trace Ln, Jacksonville, FL 32246-1396 Ph: (904) 525-3684

Reviews and Comments

Nurse Practitioner Nurses in Jacksonville, FL

Mrs. Rhode L. Jean-aleger, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10075 Gate Pkwy N Apt 102, Jacksonville, FL 32246 Phone: 904-997-9844 Fax: 904-997-9844
Jennifer Salenga Arguilla, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 8773 Perimeter Park Ct, Jacksonville, FL 32216 Phone: 904-493-3390 Fax: 904-493-3395
Jessica Pelkowski, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Christy Mcewen, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 836 Prudential Dr Ste 1700b, Unit 1, Jacksonville, FL 32207 Phone: 904-398-0125 Fax: 904-389-1832
Danielle Harper Key, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4425 Merrimac Ave, Jacksonville, FL 32210 Phone: 904-346-0050 Fax: 904-346-0080
Mr. Jeffrey Ludan Vongjesda, M.S., APRN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 3728 Philips Hwy Ste 34, Jacksonville, FL 32207 Phone: 904-399-2766 Fax: 904-549-8300
Michael Eric Bristow, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11481 Old Saint Augustine Rd Ste 303, Jacksonville, FL 32258 Phone: 904-580-4730 Fax: 904-580-4740

Elizabeth Mathew Pullukala, - Medicare Nurse Practitioner in Jacksonville, FL