Brianna Leigh Thomalla, CNP is a medicare enrolled "Nurse Practitioner - Women's Health" in Clear Lake, Minnesota. She graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Centracare Clinic and her current practice location is
4902 115th Ave, Clear Lake, Minnesota. You can reach out to her office (for appointments etc.) via phone at
(320) 333-6109.
Brianna Leigh Thomalla is licensed to practice in Minnesota (license number 8026) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1417539057.
Provider's Profile
| Full Name | Brianna Leigh Thomalla |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 4902 115th Ave, Clear Lake, Minnesota |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Brianna Leigh Thomalla graduated from nursing school in 2020
NPI Data:
- NPI Number: 1417539057
- Provider Enumeration Date: 04/23/2021
- Last Update Date: 04/23/2021
Medicare PECOS Information:
- PECOS PAC ID: 6002211265
- Enrollment ID: I20210826000009
Medical Identifiers
Medical identifiers for Brianna Leigh Thomalla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1417539057 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LW0102X | Nurse Practitioner - Women's Health | 8026 (Minnesota) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Centracare Clinic | 2466363395 | 632 |
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. Brianna Leigh Thomalla allows following entities to bill medicare on her behalf.
| Entity Name | Centracare Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043212665
PECOS PAC ID: 2466363395
Enrollment ID: O20031105000293 |
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| Entity Name | St Cloud Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043269798
PECOS PAC ID: 4880594779
Enrollment ID: O20110221000134 |
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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. Brianna Leigh Thomalla 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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Brianna Leigh Thomalla, CNP
4902 115th Ave,
Clear Lake, MN 55319-9793
Ph: (132) 033-3610 | Brianna Leigh Thomalla, CNP
4902 115th Ave,
Clear Lake, MN 55319-9793
Ph: (320) 333-6109 |
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