Carli Ann Light, APRN, CNP is a medicare enrolled "Nurse Practitioner - Pediatrics" physician in Roanoke, Illinois. Her current practice location is
401 N Main St, Roanoke, Illinois. You can reach out to her office (for appointments etc.) via phone at
(309) 923-2661.
Carli Ann Light is licensed to practice in Illinois (license number 209028999) 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 1508622275.
Physician's Profile
Full Name | Carli Ann Light |
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Gender | Female |
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Speciality | Nurse Practitioner - Pediatrics |
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Location | 401 N Main St, Roanoke, Illinois |
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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: 1508622275
- Provider Enumeration Date: 02/21/2024
- Last Update Date: 10/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 4486196359
- Enrollment ID: I20240606002272
Medical Identifiers
Medical identifiers for Carli Ann Light such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508622275 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 209.028999 (Illinois) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | 209028999 (Illinois) | 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. Carli Ann Light allows following entities to bill medicare on her behalf.
Entity Name | Saint James Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1790735421 PECOS PAC ID: 0648187252 Enrollment ID: O20040804001073 |
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Entity Name | Osf Multi-specialty Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1922445527 PECOS PAC ID: 3678889789 Enrollment ID: O20150904000279 |
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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. Carli Ann Light 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 |
Carli Ann Light, APRN, CNP 401 N Main St, Roanoke, IL 61561-7585 Ph: (309) 923-2661 | Carli Ann Light, APRN, CNP 401 N Main St, Roanoke, IL 61561-7585 Ph: (309) 923-2661 |
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