Tiesha Riann Panek, PMHNP-BC is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Cary, Illinois. Her current practice location is
10 W Main St Ste 101, Cary, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 526-3781.
Tiesha Riann Panek is licensed to practice in Illinois (license number 209026792) 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 1477250595.
Physician's Profile
| Full Name | Tiesha Riann Panek |
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| Gender | Female |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 10 W Main St Ste 101, Cary, 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: 1477250595
- Provider Enumeration Date: 02/09/2023
- Last Update Date: 02/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 7911358478
- Enrollment ID: I20240109001959
Medical Identifiers
Medical identifiers for Tiesha Riann Panek such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477250595 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 209026792 (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. Tiesha Riann Panek allows following entities to bill medicare on her behalf.
| Entity Name | Main St Psychiatry Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346756491
PECOS PAC ID: 0648535013
Enrollment ID: O20180606000720 |
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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. Tiesha Riann Panek 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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Tiesha Riann Panek, PMHNP-BC
3203 Thompson Rd,
Wonder Lake, IL 60097-8242
Ph: (815) 276-5741 | Tiesha Riann Panek, PMHNP-BC
10 W Main St Ste 101,
Cary, IL 60013-2868
Ph: (815) 526-3781 |
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