Dr Nadezda A Tretyakova, MD is a medicare enrolled "General Practice" physician in Acoma, New Mexico. Her current practice location is
80 B Veterans Blvd, I-40, Exit 102, Acoma, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(505) 552-5300.
Dr Nadezda A Tretyakova is licensed to practice in New Mexico (license number MD2013-0883) 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 1477832590.
Physician's Profile
Full Name | Dr Nadezda A Tretyakova |
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Gender | Female |
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Speciality | General Practice |
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Location | 80 B Veterans Blvd, Acoma, New Mexico |
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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: 1477832590
- Provider Enumeration Date: 08/07/2011
- Last Update Date: 07/09/2015
Medicare PECOS Information:
- PECOS PAC ID: 9032422720
- Enrollment ID: I20170926000535
Medical Identifiers
Medical identifiers for Dr Nadezda A Tretyakova such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1477832590 | NPI | - | NPPES |
H3451 | Medicaid | NM | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | MD2013-0883 (New Mexico) | 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 Nadezda A Tretyakova allows following entities to bill medicare on her behalf.
Entity Name | Emergency Staffing Solutions Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1477590974 PECOS PAC ID: 9830001650 Enrollment ID: O20070724000197 |
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Entity Name | Ess Hospitalist Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1881967305 PECOS PAC ID: 6103085295 Enrollment ID: O20120718000719 |
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Entity Name | App Of New Mexico Ed Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1891169942 PECOS PAC ID: 7416259445 Enrollment ID: O20160108000220 |
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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 Nadezda A Tretyakova 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 Nadezda A Tretyakova, MD Po Box 130, San Fidel, NM 87049-0130 Ph: (505) 552-5300 | Dr Nadezda A Tretyakova, MD 80 B Veterans Blvd, I-40, Exit 102, Acoma, NM 87034 Ph: (505) 552-5300 |
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