Anastasia Connelly, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Fallbrook, California. Her current practice location is
1461 Knoll Park Ln, Fallbrook, California. You can reach out to her office (for appointments etc.) via phone at
(909) 936-7422.
Anastasia Connelly is licensed to practice in Texas (license number 1136805) 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 1700498698.
Provider's Profile
| Full Name | Anastasia Connelly |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1461 Knoll Park Ln, Fallbrook, California |
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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: 1700498698
- Provider Enumeration Date: 08/20/2020
- Last Update Date: 09/27/2023
Medicare PECOS Information:
- PECOS PAC ID: 1759736895
- Enrollment ID: I20231010003401
Medical Identifiers
Medical identifiers for Anastasia Connelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700498698 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 95073525 (California) | Secondary |
| 163W00000X | Registered Nurse | 256741 (Arizona) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 256741 (Arizona) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 1136805 (Texas) | 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. Anastasia Connelly allows following entities to bill medicare on her behalf.
| Entity Name | Hendrick Anesthesia Network |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851394993
PECOS PAC ID: 3274521281
Enrollment ID: O20040505001856 |
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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. Anastasia Connelly 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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Anastasia Connelly,
1461 Knoll Park Ln,
Fallbrook, CA 92028-1757
Ph: (909) 936-7422 | Anastasia Connelly,
1461 Knoll Park Ln,
Fallbrook, CA 92028-1757
Ph: (909) 936-7422 |
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