Loretta Eve Wilson, FNP is a medicare enrolled "Nurse Practitioner" in Van, Texas. Her current practice location is
488 W. Main Street, Ste 101, Van, Texas. You can reach out to her office (for appointments etc.) via phone at
(903) 963-6850.
Loretta Eve Wilson is licensed to practice in Texas (license number AP121117) 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 1780952580.
Provider's Profile
Full Name | Loretta Eve Wilson |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 488 W. Main Street, Van, Texas |
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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: 1780952580
- Provider Enumeration Date: 12/07/2011
- Last Update Date: 03/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 5698937191
- Enrollment ID: I20120430000279
Medical Identifiers
Medical identifiers for Loretta Eve Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1780952580 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | AP121117 (Texas) | 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. Loretta Eve Wilson allows following entities to bill medicare on her behalf.
Entity Name | East Texas Medical Center Healthcare Associates |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1124062484 PECOS PAC ID: 3678486222 Enrollment ID: O20031114000152 |
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Entity Name | Etmc Physician Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609382662 PECOS PAC ID: 4486915600 Enrollment ID: O20180305002106 |
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Entity Name | Van Family Medical |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1386306108 PECOS PAC ID: 7113314402 Enrollment ID: O20220505001669 |
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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. Loretta Eve Wilson 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 |
Loretta Eve Wilson, FNP 488 W. Main Street, Ste 101, Van, TX 75790-2608 Ph: (903) 963-6850 | Loretta Eve Wilson, FNP 488 W. Main Street, Ste 101, Van, TX 75790-2608 Ph: (903) 963-6850 |
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