Ms Maxine Ceraolo, ARNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Port Angeles, Washington. Her current practice location is
933 E 1st St, Port Angeles, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 452-7891.
Ms Maxine Ceraolo is licensed to practice in Washington (license number AP61167344) 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 1043808405.
Healthcare Provider's Profile
| Full Name | Ms Maxine Ceraolo |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 933 E 1st St, Port Angeles, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1043808405
- Provider Enumeration Date: 12/31/2020
- Last Update Date: 10/02/2023
Medicare PECOS Information:
- PECOS PAC ID: 9638559776
- Enrollment ID: I20220706003549
Medical Identifiers
Medical identifiers for Ms Maxine Ceraolo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043808405 | NPI | - | NPPES |
| 2211667 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 103T00000X | Psychologist | AP61167344 (Washington) | Secondary |
| 163WP0808X | Registered Nurse - Psychiatric/mental Health | 417174 (Ohio) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | AP61167344 (Washington) | 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. Ms Maxine Ceraolo allows following entities to bill medicare on her behalf.
| Entity Name | North Olympic Healthcare Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154702264
PECOS PAC ID: 3779895396
Enrollment ID: O20150827003168 |
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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. Ms Maxine Ceraolo 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 |
|---|
Ms Maxine Ceraolo, ARNP
240 W Front St Ste A,
Port Angeles, WA 98362-2609
Ph: (360) 452-7891 | Ms Maxine Ceraolo, ARNP
933 E 1st St,
Port Angeles, WA 98362-4012
Ph: (360) 452-7891 |
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