Teresa A Gannon, NURSE PRACTITIONER - Medicare Nurse Practitioner in Anthem, AZ

Teresa A Gannon, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Anthem, Arizona. Her current practice location is 39621 N White Tail Ln, Anthem, Arizona. You can reach out to her office (for appointments etc.) via phone at (518) 878-7491.

Teresa A Gannon is licensed to practice in Arizona (license number 285061) 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 1821392424.

Contact Information

Teresa A Gannon, NURSE PRACTITIONER
39621 N White Tail Ln,
Anthem, AZ 85086-3683
(518) 878-7491
Not Available

Map and Direction




Provider's Profile

Full NameTeresa A Gannon
GenderFemale
SpecialityNurse Practitioner - Family
Location39621 N White Tail Ln, Anthem, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1821392424
  • Provider Enumeration Date: 12/23/2010
  • Last Update Date: 02/23/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 6002289238
  • Enrollment ID: I20230308002019

Medical Identifiers

Medical identifiers for Teresa A Gannon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1821392424NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 285061 (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. Teresa A Gannon allows following entities to bill medicare on her behalf.
Entity NameMolina Care Connections Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1407243223
PECOS PAC ID: 5799062881
Enrollment ID: O20211118001861
Entity NameBruncuso Holdings Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1497442586
PECOS PAC ID: 4789043449
Enrollment ID: O20230629000414
Entity NameBruncuso Holdings Chapter Two Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1740050822
PECOS PAC ID: 8426491093
Enrollment ID: O20240210000731

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. Teresa A Gannon 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 AddressPractice Location Address
Teresa A Gannon, NURSE PRACTITIONER
39621 N White Tail Ln,
Anthem, AZ 85086-3683

Ph: (518) 878-7491
Teresa A Gannon, NURSE PRACTITIONER
39621 N White Tail Ln,
Anthem, AZ 85086-3683

Ph: (518) 878-7491

Reviews and Comments


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Phone: 480-556-0446    Fax: 480-556-0447

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.