Alix Detullio, APN is a medicare enrolled "Clinical Nurse Specialist - Acute Care" in Freehold, New Jersey. Her current practice location is
901 W Main St, Freehold, New Jersey. You can reach out to her office (for appointments etc.) via phone at
(732) 431-0023.
Alix Detullio is licensed to practice in New Jersey (license number 26NJ00532200) 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 1043618747.
Provider's Profile
| Full Name | Alix Detullio |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Acute Care |
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| Location | 901 W Main St, Freehold, New Jersey |
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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: 1043618747
- Provider Enumeration Date: 12/11/2014
- Last Update Date: 12/11/2014
Medicare PECOS Information:
- PECOS PAC ID: 5799090304
- Enrollment ID: I20150811005576
Medical Identifiers
Medical identifiers for Alix Detullio such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1043618747 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SA2100X | Clinical Nurse Specialist - Acute Care | 26NJ00532200 (New Jersey) | 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. Alix Detullio allows following entities to bill medicare on her behalf.
| Entity Name | Freehold Hospitalists, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831231463
PECOS PAC ID: 4486754223
Enrollment ID: O20070710000428 |
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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. Alix Detullio 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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Alix Detullio, APN
4255 Route 9 N, Suite B,
Freehold, NJ 07728-8305
Ph: (732) 431-0023 | Alix Detullio, APN
901 W Main St,
Freehold, NJ 07728-2537
Ph: (732) 431-0023 |
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