Carolyn Rene Petrencik, FNP-C is a medicare enrolled "Physical Medicine & Rehabilitation" in Cedar Hill, Texas. Her current practice location is
716 N Highway 67 Ste 2, Cedar Hill, Texas. You can reach out to her office (for appointments etc.) via phone at
(972) 291-9165.
Carolyn Rene Petrencik is licensed to practice in Texas (license number 1070718) 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 1194470757.
Provider's Profile
| Full Name | Carolyn Rene Petrencik |
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| Gender | Female |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 716 N Highway 67 Ste 2, Cedar Hill, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1194470757
- Provider Enumeration Date: 02/12/2022
- Last Update Date: 10/10/2024
Medicare PECOS Information:
- PECOS PAC ID: 8921487190
- Enrollment ID: I20220617001138
Medical Identifiers
Medical identifiers for Carolyn Rene Petrencik such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1194470757 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 1070718 (Texas) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 1070718 (Texas) | 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. Carolyn Rene Petrencik allows following entities to bill medicare on her behalf.
| Entity Name | Cedar Hill Pain & Rehab, Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922148550
PECOS PAC ID: 1052402989
Enrollment ID: O20070807000762 |
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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. Carolyn Rene Petrencik 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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Carolyn Rene Petrencik, FNP-C
3408 Vista Lake Cir,
Mansfield, TX 76063-5834
Ph: (817) 919-9434 | Carolyn Rene Petrencik, FNP-C
716 N Highway 67 Ste 2,
Cedar Hill, TX 75104-2117
Ph: (972) 291-9165 |
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