Brogan Repp, is a medicare enrolled "Nurse Practitioner" in Round Lake, Illinois. Her current practice location is
34159 N Hainesville Rd, Round Lake, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 722-0063.
Brogan Repp is licensed to practice in Illinois (license number 209027936) 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 1295431823.
Provider's Profile
Full Name | Brogan Repp |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 34159 N Hainesville Rd, Round Lake, Illinois |
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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: 1295431823
- Provider Enumeration Date: 02/06/2023
- Last Update Date: 01/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 6901251974
- Enrollment ID: I20231011000869
Medical Identifiers
Medical identifiers for Brogan Repp such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295431823 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 041413004 (Illinois) | Secondary |
363L00000X | Nurse Practitioner | 209027936 (Illinois) | 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. Brogan Repp allows following entities to bill medicare on her behalf.
Entity Name | Central Dupage Physician Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1033149844 PECOS PAC ID: 5890696231 Enrollment ID: O20040303000601 |
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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. Brogan Repp 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 |
Brogan Repp, 34159 N Hainesville Rd, Round Lake, IL 60073-9790 Ph: (847) 722-0063 | Brogan Repp, 34159 N Hainesville Rd, Round Lake, IL 60073-9790 Ph: (847) 722-0063 |
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