Dr Karen Canulla, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Gravette, Arkansas. Her current practice location is
1101 Jackson St Sw, Gravette, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(479) 787-5291.
Dr Karen Canulla is licensed to practice in Arkansas (license number E-12245) 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 1477758530.
Physician's Profile
| Full Name | Dr Karen Canulla |
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| Gender | Female |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 1101 Jackson St Sw, Gravette, Arkansas |
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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: 1477758530
- Provider Enumeration Date: 06/19/2007
- Last Update Date: 07/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 2365508165
- Enrollment ID: I20191015000265
Medical Identifiers
Medical identifiers for Dr Karen Canulla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1477758530 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 36948 (Arizona) | Secondary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | E-12245 (Arkansas) | 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. Dr Karen Canulla allows following entities to bill medicare on her behalf.
| Entity Name | Sgoh Acquisition Inc |
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| Entity Type | Part B Supplier - Hospital Department(s) |
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| Entity Identifiers | NPI Number: 1568643005
PECOS PAC ID: 5092616276
Enrollment ID: O20081016000559 |
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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 Karen Canulla 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 Karen Canulla, MD
1101 Jackson St Sw,
Gravette, AR 72736-9121
Ph: (479) 787-5291 | Dr Karen Canulla, MD
1101 Jackson St Sw,
Gravette, AR 72736-9121
Ph: (479) 787-5291 |
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