Blake Erin Roseberry, FNP-BC is a medicare enrolled "Nurse Practitioner" physician in Terre Haute, Indiana. Her current practice location is
1429 N 6th St Fl 4, Terre Haute, Indiana. You can reach out to her office (for appointments etc.) via phone at
(812) 242-3175.
Blake Erin Roseberry is licensed to practice in Indiana (license number 28205992A) 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 1932810751.
Physician's Profile
| Full Name | Blake Erin Roseberry |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 1429 N 6th St Fl 4, Terre Haute, Indiana |
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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: 1932810751
- Provider Enumeration Date: 12/13/2022
- Last Update Date: 02/15/2023
Medicare PECOS Information:
- PECOS PAC ID: 7911371448
- Enrollment ID: I20230323000520
Medical Identifiers
Medical identifiers for Blake Erin Roseberry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1932810751 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207RC0000X | Internal Medicine - Cardiovascular Disease | 28205992A (Indiana) | Secondary |
| 363L00000X | Nurse Practitioner | 28205992A (Indiana) | 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. Blake Erin Roseberry allows following entities to bill medicare on her behalf.
| Entity Name | Union Associated Physicians Clinic, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891028379
PECOS PAC ID: 3375687437
Enrollment ID: O20100213000002 |
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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. Blake Erin Roseberry 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 |
|---|
Blake Erin Roseberry, FNP-BC
1429 N 6th St Fl 4,
Terre Haute, IN 47807-1019
Ph: (812) 242-3175 | Blake Erin Roseberry, FNP-BC
1429 N 6th St Fl 4,
Terre Haute, IN 47807-1019
Ph: (812) 242-3175 |
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