Mr Anthony Willert, LD, RD is a medicare enrolled "Dietitian, Registered" provider in Santo Domingo Pueblo, New Mexico. His current practice location is
85 West Highway 22, Santo Domingo Pueblo, New Mexico. You can reach out to his office (for appointments etc.) via phone at
(505) 465-3060.
Mr Anthony Willert is licensed to practice in New Mexico (license number LD-1043) 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 1417313826.
Healthcare Provider's Profile
Full Name | Mr Anthony Willert |
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Gender | Male |
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Speciality | Dietitian, Registered |
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Location | 85 West Highway 22, Santo Domingo Pueblo, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1417313826
- Provider Enumeration Date: 01/14/2016
- Last Update Date: 01/14/2016
Medicare PECOS Information:
- PECOS PAC ID: 7113201740
- Enrollment ID: I20170228000351
Medical Identifiers
Medical identifiers for Mr Anthony Willert such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1417313826 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | LD-1043 (New Mexico) | 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. Mr Anthony Willert allows following entities to bill medicare on his behalf.
Provider Name | Kewa Pueblo Health Corporation |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1467739888 PECOS PAC ID: 7618137779 Enrollment ID: O20120327000617 |
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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. Mr Anthony Willert 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 |
Mr Anthony Willert, LD, RD 8812 Avenales Ave Ne, Albuquerque, NM 87111-2315 Ph: (602) 576-2675 | Mr Anthony Willert, LD, RD 85 West Highway 22, Santo Domingo Pueblo, NM 87052 Ph: (505) 465-3060 |
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