Elyse L Diewald, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Laporte, Colorado. Her current practice location is
3817 W County Road 54g, Laporte, Colorado. You can reach out to her office (for appointments etc.) via phone at
(970) 472-2001.
Elyse L Diewald is licensed to practice in Colorado (license number APN.0997806-NP) 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 1679200497.
Provider's Profile
Full Name | Elyse L Diewald |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 3817 W County Road 54g, Laporte, Colorado |
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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: 1679200497
- Provider Enumeration Date: 08/02/2022
- Last Update Date: 08/02/2022
Medicare PECOS Information:
- PECOS PAC ID: 2567832470
- Enrollment ID: I20230110000613
Medical Identifiers
Medical identifiers for Elyse L Diewald such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1679200497 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | APN.0997806-NP (Colorado) | 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. Elyse L Diewald allows following entities to bill medicare on her behalf.
Entity Name | Banner Health Physicians Colorado Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073899134 PECOS PAC ID: 8921273038 Enrollment ID: O20111219000237 |
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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. Elyse L Diewald 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 |
Elyse L Diewald, FNP-C 3817 W County Road 54g, Laporte, CO 80535-9360 Ph: (970) 472-2001 | Elyse L Diewald, FNP-C 3817 W County Road 54g, Laporte, CO 80535-9360 Ph: (970) 472-2001 |
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