Mrs Diane Alicia Ezernack, PT in Statesville, NC - Medicare Physical Therapist Provider

Mrs Diane Alicia Ezernack, PT is a medicare enrolled "Physical Therapist" provider in Statesville, North Carolina. Her current practice location is 1414 Fern Creek Dr, Statesville, North Carolina. You can reach out to her office (for appointments etc.) via phone at (828) 459-6824.

Mrs Diane Alicia Ezernack is licensed to practice in North Carolina (license number P23026) 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 1093845711.

Contact Information

	Mrs Diane Alicia Ezernack, PT
	1414 Fern Creek Dr, Statesville, NC 28625-9376
	(828) 459-6824
	(828) 655-2344

Map and Direction

Healthcare Provider's Profile

Full Name	Mrs Diane Alicia Ezernack
Gender	Female
Speciality	Physical Therapist
Location	1414 Fern Creek Dr, Statesville, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1093845711
Provider Enumeration Date: 03/06/2007
Last Update Date: 03/27/2025

Medicare PECOS Information:

PECOS PAC ID: 7618906389
Enrollment ID: I20250418001988

Medical Identifiers

Medical identifiers for Mrs Diane Alicia Ezernack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1093845711	NPI	-	NPPES
P23026	Other	NC	PT LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	PT32489 (Florida)	Secondary
225100000X	Physical Therapist	P23026 (North Carolina)	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 Diane Alicia Ezernack allows following entities to bill medicare on her behalf.

Provider Name	Emergeortho Pa
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1376592964 PECOS PAC ID: 0749188894 Enrollment ID: O20031229000000

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 Diane Alicia Ezernack 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 Diane Alicia Ezernack, PT Po Box 5105, Belfast, ME 04915-5100 Ph: (919) 220-5255	Mrs Diane Alicia Ezernack, PT 1414 Fern Creek Dr, Statesville, NC 28625-9376 Ph: (828) 459-6824

Reviews and Comments

Physical Therapist in Statesville, NC

Shannan Lawrence, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 557 Brookdale Dr, Statesville, NC 28677 Phone: 704-873-5661
Abundant Life Physical Therapy, Llc Physical Therapist Medicare: Medicare Enrolled Practice Location: 1531 Cinema Dr Ste C, Statesville, NC 28625 Phone: 980-443-6070 Fax: 980-443-6070
Mr. Gregory W Davis, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 181 Baymount Dr, Statesville, NC 28625 Phone: 704-880-0688
Mr. Scott M Rhodes, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 218 Old Mocksville Rd, Statesville, NC 28625 Phone: 704-838-7620
Mrs. Denise Overcash Ray, MPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 889 Sherwood Ln, Statesville, NC 28677 Phone: 704-881-0088 Fax: 704-881-0087
Charles Sevier, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1845 E Broad St, Statesville, NC 28625 Phone: 980-890-3255

Mrs Diane Alicia Ezernack, PT - Medicare Physical Therapist in Statesville, NC