Antenalu Desta Tona, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Spring Lake Park, Minnesota. His current practice location is
8340 5th St Ne, Spring Lake Park, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(612) 886-5439.
Antenalu Desta Tona is licensed to practice in Minnesota (license number 10993) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1679348247.
Provider's Profile
Full Name | Antenalu Desta Tona |
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Gender | Male |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 8340 5th St Ne, Spring Lake Park, Minnesota |
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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: 1679348247
- Provider Enumeration Date: 11/23/2023
- Last Update Date: 11/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 0244774891
- Enrollment ID: I20240708000355
Medical Identifiers
Medical identifiers for Antenalu Desta Tona such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679348247 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 10993 (Minnesota) | 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. Antenalu Desta Tona allows following entities to bill medicare on his behalf.
Entity Name | Natalis Counseling And Psychology Solutions, P.a. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1447369673 PECOS PAC ID: 5193756104 Enrollment ID: O20050829000863 |
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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. Antenalu Desta Tona 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 |
Antenalu Desta Tona, 8340 5th St Ne, Spring Lake Park, MN 55432-1135 Ph: (612) 886-5439 | Antenalu Desta Tona, 8340 5th St Ne, Spring Lake Park, MN 55432-1135 Ph: (612) 886-5439 |
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