Annemarie Christopulos, is a medicare enrolled "Nurse Practitioner - Family" in South Weber, Utah. Her current practice location is
8212 Deer Run Way, South Weber, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 971-1642.
Annemarie Christopulos is licensed to practice in Utah (license number 11096359-4405) 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 1518684448.
Provider's Profile
Full Name | Annemarie Christopulos |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 8212 Deer Run Way, South Weber, Utah |
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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: 1518684448
- Provider Enumeration Date: 10/21/2022
- Last Update Date: 10/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 4789056664
- Enrollment ID: I20230203000045
Medical Identifiers
Medical identifiers for Annemarie Christopulos such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1518684448 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 11096359-4405 (Utah) | 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. Annemarie Christopulos allows following entities to bill medicare on her behalf.
Entity Name | Tanner Memorial Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1447239355 PECOS PAC ID: 4284547985 Enrollment ID: O20031110000132 |
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Entity Name | Emergency Physicians Integrated Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1578598199 PECOS PAC ID: 4284548116 Enrollment ID: O20031115000013 |
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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. Annemarie Christopulos 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 |
Annemarie Christopulos, 8212 Deer Run Way, South Weber, UT 84405-7160 Ph: (801) 971-1642 | Annemarie Christopulos, 8212 Deer Run Way, South Weber, UT 84405-7160 Ph: (801) 971-1642 |
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