Mrs Lateefa Antrom, CRNP in North Wales, PA - Medicare Nurse Practitioner

Mrs Lateefa Antrom, CRNP is a medicare enrolled "Nurse Practitioner - Family" in North Wales, Pennsylvania. Her current practice location is 1427 Horsham Rd, North Wales, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (215) 326-9065.

Mrs Lateefa Antrom is licensed to practice in Pennsylvania (license number SP015881) 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 1487017125.

Contact Information

	Mrs Lateefa Antrom, CRNP
	1427 Horsham Rd, North Wales, PA 19454-1320
	(215) 326-9065
	(215) 703-9776

Map and Direction

Provider's Profile

Full Name	Mrs Lateefa Antrom
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1427 Horsham Rd, North Wales, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487017125
Provider Enumeration Date: 03/31/2016
Last Update Date: 02/06/2023

Medicare PECOS Information:

PECOS PAC ID: 5698074375
Enrollment ID: I20160502000977

Medical Identifiers

Medical identifiers for Mrs Lateefa Antrom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487017125	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	SP015881 (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. Mrs Lateefa Antrom allows following entities to bill medicare on her behalf.

Entity Name	Wellness Medical Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1649926049 PECOS PAC ID: 3971998717 Enrollment ID: O20220315000999

Entity Name	Patient Sortal Health Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1790442077 PECOS PAC ID: 0244617389 Enrollment ID: O20220511002134

Entity Name	Wellness Medical Svcs Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1538992045 PECOS PAC ID: 7315487980 Enrollment ID: O20240910001916

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. Mrs Lateefa Antrom 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
Mrs Lateefa Antrom, CRNP 1616 Rose Ln, North Wales, PA 19454-3623 Ph: (610) 506-8509	Mrs Lateefa Antrom, CRNP 1427 Horsham Rd, North Wales, PA 19454-1320 Ph: (215) 326-9065

Reviews and Comments

Nurse Practitioner Nurses in North Wales, PA

Deborah Buck, CRNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 171 Filly Drive, North Wales, PA 19454 Phone: 215-393-7379
Ms. Diane R. Mcnickle, CRNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1425 Horsham Rd, North Wales, PA 19454 Phone: 215-371-6310
Krupali Patel, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1425 Horsham Rd, North Wales, PA 19454 Phone: 215-371-3000
Felicia Bortsoo Borketey, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 703 Santa Anita Dr, North Wales, PA 19454 Phone: 614-592-1220
Lauren Catherine Young, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 128 Annabel Rd, North Wales, PA 19454 Phone: 856-217-0799
Elizabeth Walton, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1427 Horsham Rd, North Wales, PA 19454 Phone: 215-326-9065 Fax: 215-703-9776

Mrs Lateefa Antrom, CRNP - Medicare Nurse Practitioner in North Wales, PA