Dr Nicholas George Tzanetakos, MD is a medicare enrolled "Family Medicine" physician in Montgomery, Illinois. His current practice location is
99 Boulder Hill Pass, Montgomery, Illinois. You can reach out to his office (for appointments etc.) via phone at
(630) 897-2848.
Dr Nicholas George Tzanetakos is licensed to practice in Illinois (license number 036066510) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720126535.
Physician's Profile
| Full Name | Dr Nicholas George Tzanetakos |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 99 Boulder Hill Pass, Montgomery, Illinois |
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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: 1720126535
- Provider Enumeration Date: 02/02/2007
- Last Update Date: 07/07/2017
Medicare PECOS Information:
- PECOS PAC ID: 6406035567
- Enrollment ID: I20110121000809
Medical Identifiers
Medical identifiers for Dr Nicholas George Tzanetakos such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720126535 | NPI | - | NPPES |
| 036066510 | Medicaid | IL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 036066510 (Illinois) | 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 Nicholas George Tzanetakos allows following entities to bill medicare on his behalf.
| Entity Name | Rush-copley Medical Group Nfp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093075848
PECOS PAC ID: 7618864877
Enrollment ID: O20040310001029 |
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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 Nicholas George Tzanetakos 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 |
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Dr Nicholas George Tzanetakos, MD
1256 Waterford Drive, Suite 230,
Aurora, IL 60504
Ph: (630) 499-2404 | Dr Nicholas George Tzanetakos, MD
99 Boulder Hill Pass,
Montgomery, IL 60538
Ph: (630) 897-2848 |
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