Philip Detrana, PA is a medicare enrolled "Physician Assistant - Medical" physician in Charlottesville, Virginia. His current practice location is
1240 Lee St, Charlottesville, Virginia. You can reach out to his office (for appointments etc.) via phone at
(434) 924-9333.
Philip Detrana is licensed to practice in Virginia (license number 0110010146) 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 1063255586.
Physician's Profile
Full Name | Philip Detrana |
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Gender | Male |
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Speciality | Physician Assistant - Medical |
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Location | 1240 Lee St, Charlottesville, Virginia |
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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: 1063255586
- Provider Enumeration Date: 06/13/2024
- Last Update Date: 08/14/2024
Medicare PECOS Information:
- PECOS PAC ID: 4587101159
- Enrollment ID: I20240731002590
Medical Identifiers
Medical identifiers for Philip Detrana such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063255586 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207RH0003X | Internal Medicine - Hematology & Oncology | 0110010146 (Virginia) | Secondary |
363AM0700X | Physician Assistant - Medical | 0110010146 (Virginia) | Primary |
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. Philip Detrana 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 |
Philip Detrana, PA Po Box 749112, Atlanta, GA 30374-9112 Ph: () - | Philip Detrana, PA 1240 Lee St, Charlottesville, VA 22908-0816 Ph: (434) 924-9333 |
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