Kathryn Elizabeth Douglass, CPNP in Minnetonka, MN

Kathryn Elizabeth Douglass, CPNP is a medicare enrolled "Nurse Practitioner - Pediatrics" in Minnetonka, Minnesota. Her current practice location is 17750 Hutchins Dr., Minnetonka, Minnesota. You can reach out to her office (for appointments etc.) via phone at (952) 401-8300.

Kathryn Elizabeth Douglass is licensed to practice in Minnesota (license number 20102395) 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 1497043954.

Contact Information

	Kathryn Elizabeth Douglass, CPNP
	17750 Hutchins Dr., Minnetonka, MN 55345
	(952) 401-8300
	(952) 401-8373

Map and Direction

Provider's Profile

Full Name	Kathryn Elizabeth Douglass
Gender	Female
Speciality	Nurse Practitioner - Pediatrics
Location	17750 Hutchins Dr., Minnetonka, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1497043954
Provider Enumeration Date: 07/19/2011
Last Update Date: 07/19/2011

Medicare PECOS Information:

PECOS PAC ID: 3375840820
Enrollment ID: I20160328001808

Medical Identifiers

Medical identifiers for Kathryn Elizabeth Douglass such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497043954	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0200X	Nurse Practitioner - Pediatrics	20102395 (Minnesota)	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. Kathryn Elizabeth Douglass allows following entities to bill medicare on her behalf.

Entity Name	South Lake Clinic Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427027184 PECOS PAC ID: 3173500303 Enrollment ID: O20040706000564

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. Kathryn Elizabeth Douglass 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
Kathryn Elizabeth Douglass, CPNP 17750 Hutchins Dr., Minnetonka, MN 55345 Ph: (952) 401-8300	Kathryn Elizabeth Douglass, CPNP 17750 Hutchins Dr., Minnetonka, MN 55345 Ph: (952) 401-8300

Reviews and Comments

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Kathryn Elizabeth Douglass, CPNP - Medicare Nurse Practitioner in Minnetonka, MN