Penelope Grace Ruppert, is a medicare enrolled "Nurse Practitioner - Pediatrics" in Winnetka, Illinois. Her current practice location is
572b Lincoln Ave, Winnetka, Illinois. You can reach out to her office (for appointments etc.) via phone at
(847) 501-4040.
Penelope Grace Ruppert is licensed to practice in Illinois (license number 209026393) 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 1366158529.
Provider's Profile
Full Name | Penelope Grace Ruppert |
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Gender | Female |
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Speciality | Nurse Practitioner - Pediatrics |
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Location | 572b Lincoln Ave, Winnetka, 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: 1366158529
- Provider Enumeration Date: 01/30/2023
- Last Update Date: 01/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 1355795311
- Enrollment ID: I20230925001080
Medical Identifiers
Medical identifiers for Penelope Grace Ruppert such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1366158529 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LP0200X | Nurse Practitioner - Pediatrics | 209026393 (Illinois) | 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. Penelope Grace Ruppert allows following entities to bill medicare on her behalf.
Entity Name | University Of Chicago |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1821048786 PECOS PAC ID: 7719899426 Enrollment ID: O20031103000094 |
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Entity Name | The University Of Chicago Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1033218128 PECOS PAC ID: 7618880766 Enrollment ID: O20031113000198 |
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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. Penelope Grace Ruppert 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 |
Penelope Grace Ruppert, 572b Lincoln Ave, Winnetka, IL 60093-2308 Ph: (847) 501-4040 | Penelope Grace Ruppert, 572b Lincoln Ave, Winnetka, IL 60093-2308 Ph: (847) 501-4040 |
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