Ms Emily G Pengelly, PA-C, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" in Santa Rosa, California. She went to University Of Nebraska College Of Medicine and graduated in 2010 and has 14 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice White River Family Practice Pc and her current practice location is
401 Bicentennial Way, Santa Rosa, California. You can reach out to her office (for appointments etc.) via phone at
(707) 495-3732.
Ms Emily G Pengelly is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1699072470.
Provider's Profile
| Full Name | Ms Emily G Pengelly |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 14 Years |
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| Location | 401 Bicentennial Way, Santa Rosa, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Ms Emily G Pengelly attended and graduated from University Of Nebraska College Of Medicine in 2010
NPI Data:
- NPI Number: 1699072470
- Provider Enumeration Date: 02/14/2011
- Last Update Date: 03/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 0547481699
- Enrollment ID: I20220503001779
Medical Identifiers
Medical identifiers for Ms Emily G Pengelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1699072470 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| White River Family Practice Pc | 3971561358 | 9 |
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. Ms Emily G Pengelly 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 |
|---|
Ms Emily G Pengelly, PA-C, MD
746 Pattrell Rd,
Norwich, VT 05055-9479
Ph: (210) 723-1843 | Ms Emily G Pengelly, PA-C, MD
401 Bicentennial Way,
Santa Rosa, CA 95403-2149
Ph: (707) 495-3732 |
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