Vanessa S Petit-vaval, APRN is a medicare enrolled "Nurse Practitioner" physician in Hollywood, Florida. Her current practice location is
1150 N 35th Ave Ste 560, Hollywood, Florida. You can reach out to her office (for appointments etc.) via phone at
(954) 265-1460.
Vanessa S Petit-vaval is licensed to practice in Florida (license number APRN9346924) 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 1295240497.
Physician's Profile
| Full Name | Vanessa S Petit-vaval |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 1150 N 35th Ave Ste 560, Hollywood, Florida |
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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: 1295240497
- Provider Enumeration Date: 12/10/2017
- Last Update Date: 03/19/2021
Medicare PECOS Information:
- PECOS PAC ID: 6002243029
- Enrollment ID: I20200303001740
Medical Identifiers
Medical identifiers for Vanessa S Petit-vaval such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295240497 | NPI | - | NPPES |
| 105261300 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207V00000X | Obstetrics & Gynecology | ARNP9346924 (Florida) | Secondary |
| 363L00000X | Nurse Practitioner | APRN9346924 (Florida) | 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. Vanessa S Petit-vaval allows following entities to bill medicare on her behalf.
| Entity Name | Minuteclinic Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134191836
PECOS PAC ID: 6709850241
Enrollment ID: O20070217000007 |
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| Entity Name | South Broward Hospital District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578932687
PECOS PAC ID: 8123927373
Enrollment ID: O20151219000173 |
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| Entity Name | V4 Full Circle Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861135881
PECOS PAC ID: 1759762933
Enrollment ID: O20220719002607 |
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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. Vanessa S Petit-vaval 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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Vanessa S Petit-vaval, APRN
2900 Corporate Way, Door D,
Miramar, FL 33025-3925
Ph: (954) 276-5685 | Vanessa S Petit-vaval, APRN
1150 N 35th Ave Ste 560,
Hollywood, FL 33021-5431
Ph: (954) 265-1460 |
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