Jared Petrick, in Coeur D Alene, ID - Medicare Nurse Practitioner

Jared Petrick, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Coeur D Alene, Idaho. His current practice location is 2003 Kootenai Health Way, Coeur D Alene, Idaho. You can reach out to his office (for appointments etc.) via phone at (208) 625-4870.

Jared Petrick is licensed to practice in Idaho (license number NP60612) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1932114618.

Contact Information

	Jared Petrick,
	2003 Kootenai Health Way, Coeur D Alene, ID 83814
	(208) 625-4870
	(208) 625-4878

Map and Direction

Provider's Profile

Full Name	Jared Petrick
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	2003 Kootenai Health Way, Coeur D Alene, Idaho
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932114618
Provider Enumeration Date: 07/30/2006
Last Update Date: 05/01/2024

Medicare PECOS Information:

PECOS PAC ID: 5698827590
Enrollment ID: I20190329000247

Medical Identifiers

Medical identifiers for Jared Petrick such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932114618	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	357288-4408 (Utah)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	NP60612 (Idaho)	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. Jared Petrick allows following entities to bill medicare on his behalf.

Entity Name	Kootenai Health, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235288655 PECOS PAC ID: 4789641598 Enrollment ID: O20041214000230

Entity Name	Prairie Family Medicine Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346444007 PECOS PAC ID: 5597851675 Enrollment ID: O20071020000077

Entity Name	Kootenai Health Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174661151 PECOS PAC ID: 1355792276 Enrollment ID: O20240111003252

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. Jared Petrick 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
Jared Petrick, 2003 Kootenai Health Way, Coeur D Alene, ID 83814-6051 Ph: (208) 625-5059	Jared Petrick, 2003 Kootenai Health Way, Coeur D Alene, ID 83814 Ph: (208) 625-4870

Reviews and Comments

Nurse Practitioner Nurses in Coeur D Alene, ID

Deborah Magnuson, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1090 W Park Pl, Coeur D Alene, ID 83814 Phone: 208-215-2005 Fax: 844-807-3782
Elizabeth Lynn, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1801 N 3rd St Ste 12, Coeur D Alene, ID 83814 Phone: 208-261-2411 Fax: 866-291-4766
Ms. Jayne S Shoda, MSN, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1983 E Lookout Dr, Coeur D Alene, ID 83815 Phone: 208-964-0701
Mary Sandra Duff, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 920 W Ironwood Dr, Coeur D Alene, ID 83814 Phone: 208-667-4557 Fax: 208-765-2887
Ms. Kristina Marie Follger, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 980 W Ironwood Dr Ste 302, Coeur D Alene, ID 83814 Phone: 208-292-5437 Fax: 208-292-5441
Robin Marie Beard, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 700 W Ironwood Dr Ste 120, Coeur D Alene, ID 83814 Phone: 208-625-3640 Fax: 208-625-3645
Raquel Joye Lins, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1130 W Prairie Ave, Coeur D Alene, ID 83815 Phone: 208-209-0288

Jared Petrick, - Medicare Nurse Practitioner in Coeur D Alene, ID