Mr Antonio Pedulla Jr, CRNP in North East, MD

Mr Antonio Pedulla Jr, CRNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in North East, Maryland. His current practice location is 14 Rogers Rd Ste 211, North East, Maryland. You can reach out to his office (for appointments etc.) via phone at (410) 280-7683.

Mr Antonio Pedulla Jr is licensed to practice in Pennsylvania (license number SP027026) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1518622455.

Contact Information

	Mr Antonio Pedulla Jr, CRNP
	14 Rogers Rd Ste 211, North East, MD 21901-3612
	(410) 280-7683
	(610) 702-8056

Map and Direction

Provider's Profile

Full Name	Mr Antonio Pedulla Jr
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	14 Rogers Rd Ste 211, North East, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1518622455
Provider Enumeration Date: 11/04/2021
Last Update Date: 02/13/2025

Medicare PECOS Information:

PECOS PAC ID: 4789061441
Enrollment ID: I20220518001592

Medical Identifiers

Medical identifiers for Mr Antonio Pedulla Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1518622455	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	SP024827 (Pennsylvania)	Secondary
163W00000X	Registered Nurse	RN674446 (Pennsylvania)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	SP027026 (Pennsylvania)	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. Mr Antonio Pedulla Jr allows following entities to bill medicare on his behalf.

Entity Name	Ianua Health Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1033853213 PECOS PAC ID: 3870970536 Enrollment ID: O20220518001515

Entity Name	Miamipsych Concierge Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1700368107 PECOS PAC ID: 6709262496 Enrollment ID: O20240802002616

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. Mr Antonio Pedulla Jr 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
Mr Antonio Pedulla Jr, CRNP 2207 Concord Pike # 197, Wilmington, DE 19803-2908 Ph: (610) 998-3902	Mr Antonio Pedulla Jr, CRNP 14 Rogers Rd Ste 211, North East, MD 21901-3612 Ph: (410) 280-7683

Reviews and Comments

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Mr Antonio Pedulla Jr, CRNP - Medicare Nurse Practitioner in North East, MD