Patricia Ann Pettis, APRN is a medicare enrolled "Pediatrics - Adolescent Medicine" physician in Newington, New Hampshire. Her current practice location is
100 Shattuck Way Ste 100, Newington, New Hampshire. You can reach out to her office (for appointments etc.) via phone at
(603) 431-6677.
Patricia Ann Pettis is licensed to practice in New Hampshire (license number 031898-23) 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 1104582097.
Physician's Profile
Full Name | Patricia Ann Pettis |
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Gender | Female |
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Speciality | Pediatrics - Adolescent Medicine |
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Location | 100 Shattuck Way Ste 100, Newington, New Hampshire |
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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: 1104582097
- Provider Enumeration Date: 11/15/2021
- Last Update Date: 11/15/2021
Medicare PECOS Information:
- PECOS PAC ID: 4587055652
- Enrollment ID: I20211228000845
Medical Identifiers
Medical identifiers for Patricia Ann Pettis such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104582097 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080A0000X | Pediatrics - Adolescent Medicine | 031898-23 (New Hampshire) | 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. Patricia Ann Pettis allows following entities to bill medicare on her behalf.
Entity Name | Whole Life Health Care Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1770646614 PECOS PAC ID: 6204859135 Enrollment ID: O20060106000226 |
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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. Patricia Ann Pettis 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 |
Patricia Ann Pettis, APRN 100 Shattuck Way Ste 100, Newington, NH 03801-8007 Ph: (603) 431-6677 | Patricia Ann Pettis, APRN 100 Shattuck Way Ste 100, Newington, NH 03801-8007 Ph: (603) 431-6677 |
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