Desiree M Dennull, FNP is a medicare enrolled "Nurse Practitioner" in Dexter, Oregon. Her current practice location is
38843 Dexter Rd, Dexter, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 937-2134.
Desiree M Dennull is licensed to practice in Oregon (license number 10000466) 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 1639793995.
Provider's Profile
| Full Name | Desiree M Dennull |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 38843 Dexter Rd, Dexter, Oregon |
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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: 1639793995
- Provider Enumeration Date: 06/02/2020
- Last Update Date: 02/20/2023
Medicare PECOS Information:
- PECOS PAC ID: 3072983675
- Enrollment ID: I20221222001589
Medical Identifiers
Medical identifiers for Desiree M Dennull such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1639793995 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 10000466 (Oregon) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
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. Desiree M Dennull allows following entities to bill medicare on her behalf.
| Entity Name | Peacehealth Medical Group Cottage Grove |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780631267
PECOS PAC ID: 9436060530
Enrollment ID: O20040616001333 |
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| Entity Name | Peacehealth |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1760704878
PECOS PAC ID: 6507997475
Enrollment ID: O20110104001109 |
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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. Desiree M Dennull 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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Desiree M Dennull, FNP
1115 Se 164th Ave Dept 358,
Vancouver, WA 98683-8004
Ph: (360) 729-1253 | Desiree M Dennull, FNP
38843 Dexter Rd,
Dexter, OR 97431-9600
Ph: (541) 937-2134 |
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