Ms Gweneth M Douglas, APRN in Hartford, CT - Medicare Nurse Practitioner

Ms Gweneth M Douglas, APRN is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Hartford, Connecticut. Her current practice location is 675 Tower Ave Ste 301, Hartford, Connecticut. You can reach out to her office (for appointments etc.) via phone at (860) 714-8275.

Ms Gweneth M Douglas is licensed to practice in Connecticut (license number 7942) 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 1083172811.

Contact Information

	Ms Gweneth M Douglas, APRN
	675 Tower Ave Ste 301, Hartford, CT 06112-1274
	(860) 714-8275
	(860) 714-8591

Map and Direction

Provider's Profile

Full Name	Ms Gweneth M Douglas
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	675 Tower Ave Ste 301, 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: 1083172811
Provider Enumeration Date: 03/11/2019
Last Update Date: 06/30/2020

Medicare PECOS Information:

PECOS PAC ID: 9032442520
Enrollment ID: I20190617000714

Medical Identifiers

Medical identifiers for Ms Gweneth M Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083172811	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WP0808X	Registered Nurse - Psychiatric/mental Health	7942 (Connecticut)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	7942 (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. Ms Gweneth M Douglas allows following entities to bill medicare on her behalf.

Entity Name	Connecticut Mental Health Specialists Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053362814 PECOS PAC ID: 0345130563 Enrollment ID: O20040319000165

Entity Name	Impact Health Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730694316 PECOS PAC ID: 0941562664 Enrollment ID: O20180316001315

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 Gweneth M Douglas 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 Gweneth M Douglas, APRN 675 Tower Ave Ste 301, Hartford, CT 06112-1274 Ph: (860) 714-8275	Ms Gweneth M Douglas, APRN 675 Tower Ave Ste 301, Hartford, CT 06112-1274 Ph: (860) 714-8275

Reviews and Comments

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Ms Gweneth M Douglas, APRN - Medicare Nurse Practitioner in Hartford, CT