Sheely Lopez Brockett, APRN is a medicare enrolled "Nurse Practitioner - Family" in Atwater, Ohio. Her current practice location is
3952 Laubert Rd, Atwater, Ohio. You can reach out to her office (for appointments etc.) via phone at
(408) 823-1014.
Sheely Lopez Brockett is licensed to practice in Ohio (license number APRN.CNP.0032473) 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 1467178095.
Provider's Profile
| Full Name | Sheely Lopez Brockett |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 3952 Laubert Rd, Atwater, Ohio |
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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: 1467178095
- Provider Enumeration Date: 10/14/2022
- Last Update Date: 10/14/2022
Medicare PECOS Information:
- PECOS PAC ID: 4385015528
- Enrollment ID: I20230125002671
Medical Identifiers
Medical identifiers for Sheely Lopez Brockett such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1467178095 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | APRN.CNP.0032473 (Ohio) | 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. Sheely Lopez Brockett allows following entities to bill medicare on her behalf.
| Entity Name | West Medical,inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1326077512
PECOS PAC ID: 6406958529
Enrollment ID: O20070220000798 |
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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. Sheely Lopez Brockett 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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Sheely Lopez Brockett, APRN
3952 Laubert Rd,
Atwater, OH 44201-9200
Ph: () - | Sheely Lopez Brockett, APRN
3952 Laubert Rd,
Atwater, OH 44201-9200
Ph: (408) 823-1014 |
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