Marlo Derla, APRN in Hartford, CT - Medicare Nurse Practitioner

Marlo Derla, APRN is a medicare enrolled "Nurse Practitioner" in Hartford, Connecticut. His current practice location is 114 Woodland St, Hartford, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 714-0000.

Marlo Derla is licensed to practice in Connecticut (license number 11175) 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 1013628031.

Contact Information

	Marlo Derla, APRN
	114 Woodland St, Hartford, CT 06105-1208
	(860) 714-0000
	Not Available

Map and Direction

Provider's Profile

Full Name	Marlo Derla
Gender	Male
Speciality	Nurse Practitioner
Location	114 Woodland St, Hartford, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1013628031
Provider Enumeration Date: 12/09/2022
Last Update Date: 12/09/2022

Medicare PECOS Information:

PECOS PAC ID: 0941674097
Enrollment ID: I20230313002360

Medical Identifiers

Medical identifiers for Marlo Derla such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1013628031	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	11175 (Connecticut)	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. Marlo Derla allows following entities to bill medicare on his behalf.

Entity Name	Trinity Health Of New England Provider Network Organization Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003882812 PECOS PAC ID: 0941113567 Enrollment ID: O20031110000651

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. Marlo Derla 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
Marlo Derla, APRN 63 Meadow Rd, Longmeadow, MA 01106-3026 Ph: (413) 364-7789	Marlo Derla, APRN 114 Woodland St, Hartford, CT 06105-1208 Ph: (860) 714-0000

Reviews and Comments

Nurse Practitioner Nurses in Hartford, CT

Caroline Clara Regan, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 185 Asylum St, Hartford, CT 06103 Phone: 860-215-2117
Mrs. Brooke M P Chaves, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 114 Woodland St, Hartford, CT 06105 Phone: 860-714-4680
Jocelyn Calabro, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 114 Woodland St, Hartford, CT 06105 Phone: 860-714-4000
Michael Brian Banik, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 80 Seymour St, Hartford, CT 06106 Phone: 860-545-5000
Deborah Mcgrath, APRN/FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1000 Asylum Ave, Hartford, CT 06105 Phone: 860-714-4786
Audrey Bakanauskas, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 114 Woodland St, Cardiology, Hartford, CT 06105 Phone: 860-714-4161 Fax: 860-714-8001

Marlo Derla, APRN - Medicare Nurse Practitioner in Hartford, CT