Lourdes Carolyne Pothast, FNP in Peoria, AZ - Medicare Nurse Practitioner

Lourdes Carolyne Pothast, FNP is a medicare enrolled "Nurse Practitioner - Family" in Peoria, Arizona. Her current practice location is 21753 N 77th Ave, Peoria, Arizona. You can reach out to her office (for appointments etc.) via phone at (623) 935-9600.

Lourdes Carolyne Pothast is licensed to practice in Arizona (license number 300841) 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 1992574768.

Contact Information

	Lourdes Carolyne Pothast, FNP
	21753 N 77th Ave, Peoria, AZ 85382-2110
	(623) 935-9600
	(623) 935-9602

Map and Direction

Provider's Profile

Full Name	Lourdes Carolyne Pothast
Gender	Female
Speciality	Nurse Practitioner - Family
Location	21753 N 77th Ave, Peoria, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1992574768
Provider Enumeration Date: 12/21/2023
Last Update Date: 04/29/2024

Medicare PECOS Information:

PECOS PAC ID: 8527411933
Enrollment ID: I20240131005136

Medical Identifiers

Medical identifiers for Lourdes Carolyne Pothast such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1992574768	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	300841 (Arizona)	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. Lourdes Carolyne Pothast allows following entities to bill medicare on her behalf.

Entity Name	Pinnacle Family Medicine Plc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1639208325 PECOS PAC ID: 7012015670 Enrollment ID: O20070605000288

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. Lourdes Carolyne Pothast 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
Lourdes Carolyne Pothast, FNP 14044 W Camelback Rd Ste 204, Litchfield Park, AZ 85340-9426 Ph: (623) 935-9600	Lourdes Carolyne Pothast, FNP 21753 N 77th Ave, Peoria, AZ 85382-2110 Ph: (623) 935-9600

Reviews and Comments

Nurse Practitioner Nurses in Peoria, AZ

Diana Sun Bone, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9947 West Happy Valley Parkway, # 104, Peoria, AZ 85383 Phone: 623-434-5748 Fax: 623-566-9665
Kimberly Ann Flores, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12118 W Avenida Del Rey, Peoria, AZ 85383 Phone: 419-357-0958
Jania N Davis, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 16155 N 83rd Ave Ste 211, Peoria, AZ 85382 Phone: 801-369-8989
Mr. Matthew S Burrows, APRN-NP, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13460 N 94th Dr Ste J1, Peoria, AZ 85381 Phone: 623-876-8816 Fax: 623-298-0168
Jessica Rivera, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 8101 W Louise Dr, Peoria, AZ 85383 Phone: 602-327-2421 Fax: 602-297-6964
Kimia Robinson, DNP, APRN, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13460 N 94th Dr Ste J1, Peoria, AZ 85381 Phone: 623-876-8816 Fax: 623-298-0168
Mindy Rose Magoon, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 9815 W Keyser Dr, Peoria, AZ 85383 Phone: 602-332-1519

Lourdes Carolyne Pothast, FNP - Medicare Nurse Practitioner in Peoria, AZ