Ethan Joel Dudley, in Maryville, TN - Medicare Physical Therapist In Private Practice Provider

Ethan Joel Dudley, is a medicare enrolled "Physical Therapist" provider in Maryville, Tennessee. He graduated from medical school in 2021 and has 5 years of diverse experience with area of expertise as Physical Therapist In Private Practice. He is a member of the group practice Agilitas Usa, Inc and his current practice location is 1632 W Broadway Ave, Maryville, Tennessee. You can reach out to his office (for appointments etc.) via phone at (865) 984-1996.

Ethan Joel Dudley is licensed to practice in Tennessee (license number 13412) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1750964284.

Contact Information

	Ethan Joel Dudley,
	1632 W Broadway Ave, Maryville, TN 37801-5600
	(865) 984-1996
	(865) 984-1997

Map and Direction

Healthcare Provider's Profile

Full Name	Ethan Joel Dudley
Gender	Male
Speciality	Physical Therapist In Private Practice
Experience	5 Years
Location	1632 W Broadway Ave, Maryville, Tennessee
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ethan Joel Dudley graduated from medical school in 2021

NPI Data:

NPI Number: 1750964284
Provider Enumeration Date: 05/03/2021
Last Update Date: 05/26/2021

Medicare PECOS Information:

PECOS PAC ID: 5092117655
Enrollment ID: I20210706002207

Medical Identifiers

Medical identifiers for Ethan Joel Dudley such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1750964284	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	(Tennessee)	Secondary
225100000X	Physical Therapist	13412 (Tennessee)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Agilitas Usa, Inc	3375454648	710

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. Ethan Joel Dudley allows following entities to bill medicare on his behalf.

Provider Name	Independent Physical Therapy Llc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1104878354 PECOS PAC ID: 9335056308 Enrollment ID: O20040928000202

Provider Name	Agilitas Usa, Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1962417444 PECOS PAC ID: 3375454648 Enrollment ID: O20041115000337

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. Ethan Joel Dudley 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
Ethan Joel Dudley, Po Box 306393, Nashville, TN 37230-6393 Ph: (615) 373-1350	Ethan Joel Dudley, 1632 W Broadway Ave, Maryville, TN 37801-5600 Ph: (865) 984-1996

Reviews and Comments

Physical Therapist in Maryville, TN

Lauren Levko, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1632 W Broadway Ave, Maryville, TN 37801 Phone: 865-984-1996 Fax: 865-984-1997
Mrs. Gabriel Cole, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2648 Sevierville Rd, Maryville, TN 37804 Phone: 865-738-2807 Fax: 865-238-8381
Ms. Karen P Woods, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 829 E Lamar Alexander Pkwy, Maryville, TN 37804 Phone: 865-977-8282 Fax: 865-982-0143
Eric Dale Hudgins, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2324 Market Place Dr, Maryville, TN 37801 Phone: 865-643-8681 Fax: 865-643-8682
Danielle Rene Kent, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2317 Us Highway 411 S, Maryville, TN 37801 Phone: 865-238-5338
David Brian Coleman, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1012 Jamestown Way, Maryville, TN 37803 Phone: 865-984-7400
Dr. Laura Horvath Gagnon, P.T., PH. D. Physical Therapist Medicare: Medicare Enrolled Practice Location: 2140 Colonial Cir, Maryville, TN 37803 Phone: 865-384-5593 Fax: 865-980-1728

Ethan Joel Dudley, - Medicare Physical Therapist in Maryville, TN