Katelyn Broussard, in Philadelphia, PA - Medicare Nurse Anesthetist, Certified Registered

Katelyn Broussard, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Philadelphia, Pennsylvania. Her current practice location is 3400 Spruce St, Philadelphia, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (800) 789-7366.

Katelyn Broussard is licensed to practice in Pennsylvania (license number 26NR227227100) 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 1962278234.

Contact Information

	Katelyn Broussard,
	3400 Spruce St, Philadelphia, PA 19104-4238
	(800) 789-7366
	Not Available

Map and Direction

Provider's Profile

Full Name	Katelyn Broussard
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	3400 Spruce St, Philadelphia, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962278234
Provider Enumeration Date: 11/28/2023
Last Update Date: 11/28/2023

Medicare PECOS Information:

PECOS PAC ID: 3577904416
Enrollment ID: I20240509002840

Medical Identifiers

Medical identifiers for Katelyn Broussard such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962278234	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	26NR227227100 (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. Katelyn Broussard allows following entities to bill medicare on her behalf.

Entity Name	University Of Penn-medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235527342 PECOS PAC ID: 6204730955 Enrollment ID: O20141111000091

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. Katelyn Broussard 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
Katelyn Broussard, 615 Miller St, Philadelphia, PA 19125-2721 Ph: (443) 610-8755	Katelyn Broussard, 3400 Spruce St, Philadelphia, PA 19104-4238 Ph: (800) 789-7366

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Philadelphia, PA

Victor Abarca, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 5800 Ridge Ave., Philadelphia, PA 19128 Phone: 251-483-9900
Donna Simmers, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 2301 E Allegheny Ave, Philadelphia, PA 19134 Phone: 215-291-3000
Catrina Jones, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 800 Spruce St, Philadelphia, PA 19107 Phone: 215-829-5664
Veronica Mooney, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 101 E Olney Ave, Suite 400, Philadelphia, PA 19120 Phone: 215-456-7000 Fax: 215-254-2599
Lauren Bruce, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 E Olney Ave, Suite 400, Philadelphia, PA 19120 Phone: 215-456-7000 Fax: 215-254-2599
Mrs. Jaiby V George, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3401 N. Broad Street, Philadelphia, PA 19140 Phone: 215-707-3326 Fax: 215-707-8028
Carlene M Mclaughlin, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 3400 Spruce St, Philadelphia, PA 19104 Phone: 215-349-8310

Katelyn Broussard, - Medicare Nurse Anesthetist, Certified Registered in Philadelphia, PA