Elizabeth A Petcov, CRNP is a medicare enrolled "Nurse Practitioner" physician in Lebanon, Pennsylvania. She graduated from medical school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Wellspan Medical Group and her current practice location is
252 S 4th St, Lebanon, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(717) 270-4876.
Elizabeth A Petcov is licensed to practice in Pennsylvania (license number SP017652) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1720504152.
Physician's Profile
| Full Name | Elizabeth A Petcov |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 7 Years |
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| Location | 252 S 4th St, Lebanon, Pennsylvania |
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| Accepts Medicare Assignments | Yes. She 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:
- Elizabeth A Petcov graduated from medical school in 2017
NPI Data:
- NPI Number: 1720504152
- Provider Enumeration Date: 08/17/2017
- Last Update Date: 03/01/2024
Medicare PECOS Information:
- PECOS PAC ID: 2466718283
- Enrollment ID: I20171113000143
Medical Identifiers
Medical identifiers for Elizabeth A Petcov such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720504152 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208M00000X | Hospitalist | SP017652 (Pennsylvania) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | MC4527581 (Pennsylvania) | Secondary |
| 363L00000X | Nurse Practitioner | SP017652 (Pennsylvania) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Wellspan Medical Group | 1951213115 | 1966 |
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. Elizabeth A Petcov allows following entities to bill medicare on her behalf.
| Entity Name | Wellspan Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750480299
PECOS PAC ID: 1951213115
Enrollment ID: O20040220000815 |
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| Entity Name | Good Samaritan Physician Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558749846
PECOS PAC ID: 5496728172
Enrollment ID: O20040819000854 |
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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. Elizabeth A Petcov 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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Elizabeth A Petcov, CRNP
601 Memory Ln,
York, PA 17402-2231
Ph: (717) 851-4051 | Elizabeth A Petcov, CRNP
252 S 4th St,
Lebanon, PA 17042-6111
Ph: (717) 270-4876 |
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