Carly Pecoriello Prudic, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Bayfield, Colorado. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Total Healthcare, Catholic Health Initiatives Colorado and her current practice location is
480 Wolverine Dr Ste 3, Bayfield, Colorado. You can reach out to her office (for appointments etc.) via phone at
(970) 764-9150.
Carly Pecoriello Prudic is licensed to practice in Colorado (license number C-APN.0003335-C-NP) 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 1306498860.
Provider's Profile
| Full Name | Carly Pecoriello Prudic |
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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 | 480 Wolverine Dr Ste 3, Bayfield, Colorado |
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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:
- Carly Pecoriello Prudic graduated from nursing school in 2019
NPI Data:
- NPI Number: 1306498860
- Provider Enumeration Date: 07/15/2019
- Last Update Date: 07/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 0941530778
- Enrollment ID: I20211103002186
Medical Identifiers
Medical identifiers for Carly Pecoriello Prudic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306498860 | NPI | - | NPPES |
| 9000198265 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | RN-79812 (New Mexico) | Secondary |
| 363L00000X | Nurse Practitioner | C-APN.0003335-C-NP (Colorado) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 568903 (New Mexico) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | C-APN.0003335-C-NP (Colorado) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Total Healthcare | 1052214814 | 28 |
| Catholic Health Initiatives Colorado | 8022927342 | 972 |
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. Carly Pecoriello Prudic allows following entities to bill medicare on her behalf.
| Entity Name | Catholic Health Initiatives Colorado |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356783351
PECOS PAC ID: 8022927342
Enrollment ID: O20031215000462 |
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| Entity Name | Total Healthcare |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669420410
PECOS PAC ID: 1052214814
Enrollment ID: O20040129000282 |
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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. Carly Pecoriello Prudic 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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Carly Pecoriello Prudic, FNP-BC
480 Wolverine Dr Ste 3,
Bayfield, CO 81122-9653
Ph: (707) 649-1509 | Carly Pecoriello Prudic, FNP-BC
480 Wolverine Dr Ste 3,
Bayfield, CO 81122-9653
Ph: (970) 764-9150 |
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