Breanna Caudle, OTD- OT is a medicare enrolled "Occupational Therapist" provider in Salt Lake City, Utah. Her current practice location is
1950 Circle Of Hope Dr, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at
(314) 703-1816.
Breanna Caudle is licensed to practice in Utah (license number 9383425-4201) 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 1346407673.
Healthcare Provider's Profile
| Full Name | Breanna Caudle |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 1950 Circle Of Hope Dr, Salt Lake City, Utah |
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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: 1346407673
- Provider Enumeration Date: 05/22/2008
- Last Update Date: 12/20/2021
Medicare PECOS Information:
- PECOS PAC ID: 2365844370
- Enrollment ID: I20210714000707
Medical Identifiers
Medical identifiers for Breanna Caudle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1346407673 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 225X00000X | Occupational Therapist | 9383425-4201 (Utah) | 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. Breanna Caudle allows following entities to bill medicare on her behalf.
| Entity Name | University Of Utah |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588656870
PECOS PAC ID: 0749262665
Enrollment ID: O20050629000441 |
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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. Breanna Caudle 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 |
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Breanna Caudle, OTD- OT
1950 Circle Of Hope Dr,
Salt Lake City, UT 84112-5500
Ph: (314) 703-1816 | Breanna Caudle, OTD- OT
1950 Circle Of Hope Dr,
Salt Lake City, UT 84112-5500
Ph: (314) 703-1816 |
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