Derrick Christopher Penticuff, in Pueblo, CO - Medicare Physical Therapist Provider

Derrick Christopher Penticuff, is a medicare enrolled "Physical Therapist" provider in Pueblo, Colorado. His current practice location is 4115 Club Manor Dr, Pueblo, Colorado. You can reach out to his office (for appointments etc.) via phone at (968) 568-9790.

Derrick Christopher Penticuff is licensed to practice in * (Not Available) (license number ) 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 1770107179.

Contact Information

	Derrick Christopher Penticuff,
	4115 Club Manor Dr, Pueblo, CO 81008
	(968) 568-9790
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Derrick Christopher Penticuff
Gender	Male
Speciality	Physical Therapist
Location	4115 Club Manor Dr, Pueblo, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1770107179
Provider Enumeration Date: 06/01/2020
Last Update Date: 04/12/2023

Medicare PECOS Information:

PECOS PAC ID: 5496133514
Enrollment ID: I20220602000084

Medical Identifiers

Medical identifiers for Derrick Christopher Penticuff such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770107179	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	(* (Not Available))	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. Derrick Christopher Penticuff allows following entities to bill medicare on his behalf.

Provider Name	Synergy Physical Therapy And Wellness
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1437572583 PECOS PAC ID: 5991920001 Enrollment ID: O20140703001634

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. Derrick Christopher Penticuff 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
Derrick Christopher Penticuff, 4115 Club Manor Dr., Pueblo, CO 81008 Ph: (417) 709-5228	Derrick Christopher Penticuff, 4115 Club Manor Dr, Pueblo, CO 81008 Ph: (968) 568-9790

Reviews and Comments

Physical Therapist in Pueblo, CO

Karen Bishop, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 4112 Outlook Blvd, Ste 96, Pueblo, CO 81008 Phone: 719-266-1788 Fax: 719-776-4700
Michelle Perse, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 4115 Club Manor Drive, Pueblo, CO 81008 Phone: 719-568-9790
Dane M Farnworth, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3525 Spaulding Ave, Pueblo, CO 81008 Phone: 719-542-4444 Fax: 719-543-1990
Cydne Rossi, Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1275 W Pueblo Blvd, Pueblo, CO 81004 Phone: 719-542-0589
Todd S Chilson, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 387 E Enterprise Dr Ste 160, Pueblo, CO 81007 Phone: 719-924-8912 Fax: 719-696-9115
Mary Margaret Whelan Leffert, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1209 Paseo Del Norte Ste 3, Pueblo, CO 81008 Phone: 719-569-5691 Fax: 719-569-5689
Shannon A Egan, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1275 W Pueblo Blvd, Pueblo, CO 81004 Phone: 719-542-0589 Fax: 719-542-0119

Derrick Christopher Penticuff, - Medicare Physical Therapist in Pueblo, CO