Breanna Coulardot, in Louisville, KY - Medicare Nurse Practitioner

Breanna Coulardot, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Louisville, Kentucky. Her current practice location is 4011 Gardiner Point Dr Ste 101, Louisville, Kentucky. You can reach out to her office (for appointments etc.) via phone at (502) 451-5121.

Breanna Coulardot is licensed to practice in Kentucky (license number 4015287) 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 1215662135.

Contact Information

	Breanna Coulardot,
	4011 Gardiner Point Dr Ste 101, Louisville, KY 40213-1988
	(502) 451-5121
	Not Available

Map and Direction

Provider's Profile

Full Name	Breanna Coulardot
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	4011 Gardiner Point Dr Ste 101, Louisville, Kentucky
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215662135
Provider Enumeration Date: 07/24/2022
Last Update Date: 01/29/2024

Medicare PECOS Information:

PECOS PAC ID: 8325482342
Enrollment ID: I20240219000598

Medical Identifiers

Medical identifiers for Breanna Coulardot such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215662135	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	1163444 (Kentucky)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	4015287 (Kentucky)	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. Breanna Coulardot allows following entities to bill medicare on her behalf.

Entity Name	Sullivan Psychiatric Group, Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1366879025 PECOS PAC ID: 4486913530 Enrollment ID: O20180117001656

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. Breanna Coulardot 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
Breanna Coulardot, 107 Pennyrile Dr, Coxs Creek, KY 40013-6652 Ph: () -	Breanna Coulardot, 4011 Gardiner Point Dr Ste 101, Louisville, KY 40213-1988 Ph: (502) 451-5121

Reviews and Comments

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Breanna Coulardot, - Medicare Nurse Practitioner in Louisville, KY