Petra Rosa Mojica, is a medicare enrolled "Nurse Practitioner - Family" in Arizona City, Arizona. Her current practice location is
14574 S Sunland Gin Rd, Arizona City, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 387-5651.
Petra Rosa Mojica is licensed to practice in Arizona (license number 280587) 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 1457922783.
Provider's Profile
| Full Name | Petra Rosa Mojica |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 14574 S Sunland Gin Rd, Arizona City, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1457922783
- Provider Enumeration Date: 07/07/2021
- Last Update Date: 09/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 9638530082
- Enrollment ID: I20230801002450
Medical Identifiers
Medical identifiers for Petra Rosa Mojica such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1457922783 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 280587 (Arizona) | Primary |
| 363LF0000X | Nurse Practitioner - Family | F06211981 (Arizona) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | F0621181 (Texas) | Secondary |
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. Petra Rosa Mojica allows following entities to bill medicare on her behalf.
| Entity Name | Oak Street Health Of Texas Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1497387419
PECOS PAC ID: 2163843038
Enrollment ID: O20200601001767 |
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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. Petra Rosa Mojica 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 |
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Petra Rosa Mojica,
410 N Malacate St,
Ajo, AZ 85321-2254
Ph: () - | Petra Rosa Mojica,
14574 S Sunland Gin Rd,
Arizona City, AZ 85123
Ph: (520) 387-5651 |
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