Merrill Depetrillo, NP is a medicare enrolled "Nurse Practitioner" physician in Jasper, Georgia. Her current practice location is
1266 Highway 515 S, Jasper, Georgia. You can reach out to her office (for appointments etc.) via phone at
(706) 692-2441.
Merrill Depetrillo is licensed to practice in Georgia (license number RN108911 NP) 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 1366458192.
Physician's Profile
| Full Name | Merrill Depetrillo |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 1266 Highway 515 S, Jasper, Georgia |
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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: 1366458192
- Provider Enumeration Date: 08/01/2006
- Last Update Date: 01/16/2024
Medicare PECOS Information:
- PECOS PAC ID: 2567812985
- Enrollment ID: I20231228000332
Medical Identifiers
Medical identifiers for Merrill Depetrillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366458192 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207RC0000X | Internal Medicine - Cardiovascular Disease | RN108911 (Georgia) | Secondary |
| 363L00000X | Nurse Practitioner | RN108911 NP (Georgia) | 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. Merrill Depetrillo allows following entities to bill medicare on her behalf.
| Entity Name | Piedmont Cardiology Of Atlanta, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275729691
PECOS PAC ID: 0345321691
Enrollment ID: O20080114000153 |
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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. Merrill Depetrillo 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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Merrill Depetrillo, NP
6010 Riley Rd,
Cumming, GA 30028-5927
Ph: () - | Merrill Depetrillo, NP
1266 Highway 515 S,
Jasper, GA 30143-4872
Ph: (706) 692-2441 |
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