Diane Marie Coughlan, CRNP is a medicare enrolled "Nurse Practitioner" in Upper Chichester, Pennsylvania. Her current practice location is
4115 Chichester Ave, Upper Chichester, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(610) 484-4422.
Diane Marie Coughlan is licensed to practice in Pennsylvania (license number SP011208) 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 1124322508.
Provider's Profile
Full Name | Diane Marie Coughlan |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 4115 Chichester Ave, Upper Chichester, Pennsylvania |
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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: 1124322508
- Provider Enumeration Date: 12/29/2010
- Last Update Date: 10/20/2023
Medicare PECOS Information:
- PECOS PAC ID: 1759565302
- Enrollment ID: I20110406000682
Medical Identifiers
Medical identifiers for Diane Marie Coughlan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124322508 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | SP011208 (Pennsylvania) | 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. Diane Marie Coughlan allows following entities to bill medicare on her behalf.
Entity Name | Bridges Palliative Care Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598180382 PECOS PAC ID: 5698992493 Enrollment ID: O20140818001688 |
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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. Diane Marie Coughlan 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 |
Diane Marie Coughlan, CRNP 4115 Chichester Ave, Upper Chichester, PA 19061-3139 Ph: (610) 484-4422 | Diane Marie Coughlan, CRNP 4115 Chichester Ave, Upper Chichester, PA 19061-3139 Ph: (610) 484-4422 |
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