Diane Goedecke, FNP is a medicare enrolled "Nurse Practitioner - Family" physician in Tucson, Arizona. Her current practice location is
6130 N La Cholla Blvd Ste 250, Tucson, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 219-8690.
Diane Goedecke is licensed to practice in Arizona (license number RN044164) 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 1205940293.
Physician's Profile
Full Name | Diane Goedecke |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 6130 N La Cholla Blvd Ste 250, Tucson, Arizona |
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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: 1205940293
- Provider Enumeration Date: 08/18/2006
- Last Update Date: 09/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 8729137294
- Enrollment ID: I20090513000322
Medical Identifiers
Medical identifiers for Diane Goedecke such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1205940293 | NPI | - | NPPES |
494253 | Medicaid | AZ | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207V00000X | Obstetrics & Gynecology | RN044164 (Arizona) | Secondary |
363LF0000X | Nurse Practitioner - Family | RN044164 (Arizona) | 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. Diane Goedecke allows following entities to bill medicare on her behalf.
Entity Name | Old Pueblo Healthcare Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1306890793 PECOS PAC ID: 4981607512 Enrollment ID: O20060821000095 |
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Entity Name | Northwest Allied Physicians Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1003833179 PECOS PAC ID: 7618972514 Enrollment ID: O20060928000110 |
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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. Diane Goedecke 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 |
Diane Goedecke, FNP 6130 N La Cholla Blvd Ste 250, Tucson, AZ 85741-3698 Ph: (520) 219-8690 | Diane Goedecke, FNP 6130 N La Cholla Blvd Ste 250, Tucson, AZ 85741-3698 Ph: (520) 219-8690 |
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