Dr Eric Evan Petterson, MD is a medicare enrolled "Internal Medicine - Addiction Medicine" physician in Shenandoah, Pennsylvania. He graduated from medical school in 1981 and has 43 years of diverse experience with area of expertise as Hospitalist. His current practice location is
1 S Main St, Shenandoah, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(570) 462-1040.
Dr Eric Evan Petterson is licensed to practice in Pennsylvania (license number MD039636L) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1245269547.
Physician's Profile
| Full Name | Dr Eric Evan Petterson |
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| Gender | Male |
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| Speciality | Hospitalist |
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| Experience | 43 Years |
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| Location | 1 S Main St, Shenandoah, Pennsylvania |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Eric Evan Petterson graduated from medical school in 1981
NPI Data:
- NPI Number: 1245269547
- Provider Enumeration Date: 07/01/2006
- Last Update Date: 11/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 0749229532
- Enrollment ID: I20050503000144
Medical Identifiers
Medical identifiers for Dr Eric Evan Petterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245269547 | NPI | - | NPPES |
| 0010036980010 | Medicaid | PA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | MD039636L (Pennsylvania) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | MD039636L (Pennsylvania) | Primary |
Medical Facilities Affiliation
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. Dr Eric Evan Petterson allows following entities to bill medicare on his behalf.
| Entity Name | Eric E Petterson Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245787530
PECOS PAC ID: 1153360938
Enrollment ID: O20050502000186 |
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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. Dr Eric Evan Petterson 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 |
|---|
Dr Eric Evan Petterson, MD
411 W Pine St,
Mahanoy City, PA 17948-2515
Ph: (570) 462-1040 | Dr Eric Evan Petterson, MD
1 S Main St,
Shenandoah, PA 17976-2332
Ph: (570) 462-1040 |
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