Katerina Fagan, ACNPC-AG is a medicare enrolled "Urology" in Crestview, Florida. She graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Emerald Coast Urology, Llc, North Okaloosa Clinic Corp and her current practice location is
435 Brookmeade Dr, Crestview, Florida. You can reach out to her office (for appointments etc.) via phone at
(850) 605-0550.
Katerina Fagan is licensed to practice in Florida (license number 11031708) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1356911671.
Provider's Profile
| Full Name | Katerina Fagan |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 435 Brookmeade Dr, Crestview, Florida |
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| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Katerina Fagan graduated from nursing school in 2021
NPI Data:
- NPI Number: 1356911671
- Provider Enumeration Date: 06/29/2021
- Last Update Date: 05/19/2026
Medicare PECOS Information:
- PECOS PAC ID: 4486093648
- Enrollment ID: I20240419003012
Medical Identifiers
Medical identifiers for Katerina Fagan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1356911671 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LA2100X | Nurse Practitioner - Acute Care | APRN11031708 (Florida) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 1046195 (Texas) | Secondary |
| 208800000X | Urology | 11031708 (Florida) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Emerald Coast Urology, Llc | 8224503859 | 2 |
| North Okaloosa Clinic Corp | 0244205565 | 27 |
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. Katerina Fagan allows following entities to bill medicare on her behalf.
| Entity Name | North Okaloosa Clinic Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659329852
PECOS PAC ID: 0244205565
Enrollment ID: O20040831000576 |
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| Entity Name | Emerald Coast Urology, LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033063268
PECOS PAC ID: 8224503859
Enrollment ID: O20260410001370 |
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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. Katerina Fagan 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 |
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Katerina Fagan, ACNPC-AG
Po Box 1027,
Niceville, FL 32588-1027
Ph: (850) 605-0550 | Katerina Fagan, ACNPC-AG
435 Brookmeade Dr,
Crestview, FL 32539-7304
Ph: (850) 605-0550 |
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