Mr Antonio Pedulla Jr, CRNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Nottingham, Pennsylvania. His current practice location is
680 Fremont Rd, Nottingham, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(610) 733-8627.
Mr Antonio Pedulla Jr is licensed to practice in Pennsylvania (license number SP027026) 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 1518622455.
Provider's Profile
Full Name | Mr Antonio Pedulla Jr |
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Gender | Male |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 680 Fremont Rd, Nottingham, Pennsylvania |
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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: 1518622455
- Provider Enumeration Date: 11/04/2021
- Last Update Date: 02/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 4789061441
- Enrollment ID: I20220518001592
Medical Identifiers
Medical identifiers for Mr Antonio Pedulla Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1518622455 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | RN674446 (Pennsylvania) | Secondary |
363LF0000X | Nurse Practitioner - Family | SP024827 (Pennsylvania) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | SP027026 (Pennsylvania) | 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. Mr Antonio Pedulla Jr allows following entities to bill medicare on his behalf.
Entity Name | Ianua Health Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1033853213 PECOS PAC ID: 3870970536 Enrollment ID: O20220518001515 |
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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. Mr Antonio Pedulla Jr 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 |
Mr Antonio Pedulla Jr, CRNP 680 Fremont Rd, Nottingham, PA 19362-9142 Ph: (610) 733-8627 | Mr Antonio Pedulla Jr, CRNP 680 Fremont Rd, Nottingham, PA 19362-9142 Ph: (610) 733-8627 |
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