Ebony Sharette Penn, in Belleville, IL - Medicare Nurse Practitioner

Ebony Sharette Penn, is a medicare enrolled "Nurse Practitioner - Family" in Belleville, Illinois. Her current practice location is 1720 Shadow Ridge Ct Apt H, Belleville, Illinois. You can reach out to her office (for appointments etc.) via phone at (618) 409-3082.

Ebony Sharette Penn is licensed to practice in Illinois (license number 209022466) 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 1477137693.

Contact Information

	Ebony Sharette Penn,
	1720 Shadow Ridge Ct Apt H, Belleville, IL 62221-3914
	(618) 409-3082
	Not Available

Map and Direction

Provider's Profile

Full Name	Ebony Sharette Penn
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1720 Shadow Ridge Ct Apt H, Belleville, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477137693
Provider Enumeration Date: 05/12/2021
Last Update Date: 05/12/2021

Medicare PECOS Information:

PECOS PAC ID: 7911373428
Enrollment ID: I20221024002326

Medical Identifiers

Medical identifiers for Ebony Sharette Penn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477137693	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	209022466 (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. Ebony Sharette Penn allows following entities to bill medicare on her behalf.

Entity Name	Molina Care Connections Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407243223 PECOS PAC ID: 5799062881 Enrollment ID: O20180301000229

Entity Name	Signify Health Medical Associates Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20190507001451

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. Ebony Sharette Penn 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
Ebony Sharette Penn, 1720 Shadow Ridge Ct Apt H, Belleville, IL 62221-3914 Ph: (618) 409-3082	Ebony Sharette Penn, 1720 Shadow Ridge Ct Apt H, Belleville, IL 62221-3914 Ph: (618) 409-3082

Reviews and Comments

Nurse Practitioner Nurses in Belleville, IL

Kelsey Beasley, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3060 Harvest Meadow Dr, Belleville, IL 62221 Phone: 618-792-8887
Ms. Lauren Nicole Marshall, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-257-5455 Fax: 618-257-4490
Mr. Lito T Rufin, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-257-6220
Cindy L. Auld, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Ste. 400, Belleville, IL 62226 Phone: 618-234-2390 Fax: 618-234-9936
Pamela A O'neal, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 130 Lincoln Place Ct, Belleville, IL 62221 Phone: 618-257-2029 Fax: 618-235-5371
Mrs. Deanna L. Rodenberg, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4550 Memorial Dr, Ste. 340, Belleville, IL 62226 Phone: 618-257-6200 Fax: 618-257-6679
Katherine Ann Combs, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4700 Memorial Dr Ste 250, Belleville, IL 62226 Phone: 618-212-6560

Ebony Sharette Penn, - Medicare Nurse Practitioner in Belleville, IL