Mrs Caitlyn Clare Wagenbach, PA-C is a medicare enrolled "Physician Assistant" in Peoria Heights, Illinois. Her current practice location is
4616 N Prospect Rd, Peoria Heights, Illinois. You can reach out to her office (for appointments etc.) via phone at
(217) 528-7541.
Mrs Caitlyn Clare Wagenbach is licensed to practice in * (Not Available) (license number ) 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 1346856846.
Provider's Profile
Full Name | Mrs Caitlyn Clare Wagenbach |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 4616 N Prospect Rd, Peoria Heights, Illinois |
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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: 1346856846
- Provider Enumeration Date: 09/20/2020
- Last Update Date: 10/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 0840672531
- Enrollment ID: I20220727002651
Medical Identifiers
Medical identifiers for Mrs Caitlyn Clare Wagenbach such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1346856846 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
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. Mrs Caitlyn Clare Wagenbach 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 |
Mrs Caitlyn Clare Wagenbach, PA-C Po Box 19248, Springfield, IL 62794-9248 Ph: (217) 528-7541 | Mrs Caitlyn Clare Wagenbach, PA-C 4616 N Prospect Rd, Peoria Heights, IL 61616-6460 Ph: (217) 528-7541 |
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