Mrs Teresa M Conklin, FNP in South Orange, NJ

Mrs Teresa M Conklin, FNP is a medicare enrolled "Nurse Practitioner - Family" in South Orange, New Jersey. Her current practice location is 400 S Orange Ave, South Orange, New Jersey. You can reach out to her office (for appointments etc.) via phone at (973) 761-9175.

Mrs Teresa M Conklin is licensed to practice in New Jersey (license number 26NO09584600) 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 1275769176.

Contact Information

	Mrs Teresa M Conklin, FNP
	400 S Orange Ave, South Orange, NJ 07079-2646
	(973) 761-9175
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Teresa M Conklin
Gender	Female
Speciality	Nurse Practitioner - Family
Location	400 S Orange Ave, South Orange, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1275769176
Provider Enumeration Date: 06/05/2009
Last Update Date: 07/14/2014

Medicare PECOS Information:

PECOS PAC ID: 1153686662
Enrollment ID: I20180605000829

Medical Identifiers

Medical identifiers for Mrs Teresa M Conklin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275769176	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	26NO09584600 (New Jersey)	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. Mrs Teresa M Conklin allows following entities to bill medicare on her behalf.

Entity Name	On Site Dermatology Of New Jersey Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811389539 PECOS PAC ID: 1951616697 Enrollment ID: O20150811003325

Entity Name	Somdocs
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508390832 PECOS PAC ID: 8123381811 Enrollment ID: O20180411000336

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 Teresa M Conklin 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 Teresa M Conklin, FNP 18 W Blackwell St, Dover, NJ 07801-3841 Ph: () -	Mrs Teresa M Conklin, FNP 400 S Orange Ave, South Orange, NJ 07079-2646 Ph: (973) 761-9175

Reviews and Comments

Nurse Practitioner Nurses in South Orange, NJ

Oneka Edwards, APN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 20 Valley St Ste 320, South Orange, NJ 07079 Phone: 973-313-1113
Samantha R Minott, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 20 Valley St Ste 320, South Orange, NJ 07079 Phone: 973-313-1113
Tonya S. Brissett, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 62 5th Street, South Orange, NJ 07079 Phone: 201-906-7966
Ms. Natasha N Ashton, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 418 Academy St, South Orange, NJ 07079 Phone: 201-259-1470 Fax: 973-761-7012
Kemoy Fong, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 707 S Orange Ave, South Orange, NJ 07079 Phone: 973-761-6111
Ms. Mary Elizabeth Costello, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 400 South Orange Avenue, Seton Hall University Health Services, South Orange, NJ 07079 Phone: 973-761-9175 Fax: 973-761-9193

Mrs Teresa M Conklin, FNP - Medicare Nurse Practitioner in South Orange, NJ