Annika Elizabeth Dethlefs, FNP-BC in Folsom, CA

Annika Elizabeth Dethlefs, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Folsom, California. Her current practice location is 82 Clarksville Rd Ste 120, Folsom, California. You can reach out to her office (for appointments etc.) via phone at (916) 983-8868.

Annika Elizabeth Dethlefs is licensed to practice in California (license number 95023461) 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 1013627165.

Contact Information

	Annika Elizabeth Dethlefs, FNP-BC
	82 Clarksville Rd Ste 120, Folsom, CA 95630-8210
	(916) 983-8868
	Not Available

Map and Direction

Provider's Profile

Full Name	Annika Elizabeth Dethlefs
Gender	Female
Speciality	Nurse Practitioner - Family
Location	82 Clarksville Rd Ste 120, Folsom, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013627165
Provider Enumeration Date: 11/30/2022
Last Update Date: 01/15/2024

Medicare PECOS Information:

PECOS PAC ID: 4082085261
Enrollment ID: I20230126000791

Medical Identifiers

Medical identifiers for Annika Elizabeth Dethlefs such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013627165	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95023461 (California)	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. Annika Elizabeth Dethlefs allows following entities to bill medicare on her behalf.

Entity Name	Healthy Living Primary Care Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144414293 PECOS PAC ID: 7618062225 Enrollment ID: O20070927000419

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. Annika Elizabeth Dethlefs 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
Annika Elizabeth Dethlefs, FNP-BC 965 Wilson Blvd Apt 1331, El Dorado Hills, CA 95762-7262 Ph: (916) 817-0512	Annika Elizabeth Dethlefs, FNP-BC 82 Clarksville Rd Ste 120, Folsom, CA 95630-8210 Ph: (916) 983-8868

Reviews and Comments

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Annika Elizabeth Dethlefs, FNP-BC - Medicare Nurse Practitioner in Folsom, CA