Petra Spencer, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Derwood, Maryland. Her current practice location is
16211 Redland Rd, Derwood, Maryland. You can reach out to her office (for appointments etc.) via phone at
(210) 542-2011.
Petra Spencer is licensed to practice in Maryland (license number AC003797) 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 1083202048.
Provider's Profile
Full Name | Petra Spencer |
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Gender | Female |
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Speciality | Nurse Anesthetist, Certified Registered |
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Location | 16211 Redland Rd, Derwood, Maryland |
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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: 1083202048
- Provider Enumeration Date: 01/05/2021
- Last Update Date: 01/28/2023
Medicare PECOS Information:
- PECOS PAC ID: 9436510724
- Enrollment ID: I20230802004335
Medical Identifiers
Medical identifiers for Petra Spencer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083202048 | NPI | - | NPPES |
NONE | Other | | NONE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | RN9519497 (Florida) | Secondary |
367500000X | Nurse Anesthetist, Certified Registered | AC003797 (Maryland) | 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. Petra Spencer allows following entities to bill medicare on her behalf.
Entity Name | Lifebridge Anesthesia Associates Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1003992868 PECOS PAC ID: 2062514888 Enrollment ID: O20230627000605 |
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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 Spencer 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 |
Petra Spencer, CRNA 16211 Redland Rd, Derwood, MD 20855-2133 Ph: () - | Petra Spencer, CRNA 16211 Redland Rd, Derwood, MD 20855-2133 Ph: (210) 542-2011 |
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