Courtney Nicole Petz, MD is a medicare enrolled "Family Medicine" physician in Wellsville, Kansas. Her current practice location is
424 Main St, Wellsville, Kansas. You can reach out to her office (for appointments etc.) via phone at
(785) 883-4863.
Courtney Nicole Petz is licensed to practice in Kansas (license number 0450067) 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 1740861657.
Physician's Profile
| Full Name | Courtney Nicole Petz |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 424 Main St, Wellsville, Kansas |
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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: 1740861657
- Provider Enumeration Date: 04/21/2021
- Last Update Date: 10/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 1557764180
- Enrollment ID: I20241209001763
Medical Identifiers
Medical identifiers for Courtney Nicole Petz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740861657 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 0450067 (Kansas) | 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. Courtney Nicole Petz allows following entities to bill medicare on her behalf.
| Entity Name | Adventhealth Ransom Memorial Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407319957
PECOS PAC ID: 4486996907
Enrollment ID: O20190510001418 |
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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. Courtney Nicole Petz 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 |
|---|
Courtney Nicole Petz, MD
424 Main St,
Wellsville, KS 66092-8878
Ph: (785) 883-4863 | Courtney Nicole Petz, MD
424 Main St,
Wellsville, KS 66092-8878
Ph: (785) 883-4863 |
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