Teresa A Gannon, NURSE PRACTITIONER in Anthem, AZ

Teresa A Gannon, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Anthem, Arizona. Her current practice location is 39621 N White Tail Ln, Anthem, Arizona. You can reach out to her office (for appointments etc.) via phone at (518) 878-7491.

Teresa A Gannon is licensed to practice in Arizona (license number 285061) 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 1821392424.

Contact Information

	Teresa A Gannon, NURSE PRACTITIONER
	39621 N White Tail Ln, Anthem, AZ 85086-3683
	(518) 878-7491
	Not Available

Map and Direction

Provider's Profile

Full Name	Teresa A Gannon
Gender	Female
Speciality	Nurse Practitioner - Family
Location	39621 N White Tail Ln, Anthem, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1821392424
Provider Enumeration Date: 12/23/2010
Last Update Date: 02/23/2023

Medicare PECOS Information:

PECOS PAC ID: 6002289238
Enrollment ID: I20230308002019

Medical Identifiers

Medical identifiers for Teresa A Gannon such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1821392424	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	285061 (Arizona)	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. Teresa A Gannon allows following entities to bill medicare on her behalf.

Entity Name	Molina Care Connections Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407243223 PECOS PAC ID: 5799062881 Enrollment ID: O20211118001861

Entity Name	Bruncuso Holdings Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497442586 PECOS PAC ID: 4789043449 Enrollment ID: O20230629000414

Entity Name	Bruncuso Holdings Chapter Two Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740050822 PECOS PAC ID: 8426491093 Enrollment ID: O20240210000731

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. Teresa A Gannon 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
Teresa A Gannon, NURSE PRACTITIONER 39621 N White Tail Ln, Anthem, AZ 85086-3683 Ph: (518) 878-7491	Teresa A Gannon, NURSE PRACTITIONER 39621 N White Tail Ln, Anthem, AZ 85086-3683 Ph: (518) 878-7491

Reviews and Comments

Nurse Practitioner Nurses in Anthem, AZ

Mr. Todd A Adams, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 41818 N Venture Dr Ste 150, Anthem, AZ 85086 Phone: 623-400-1501
Lauren Bisswurm, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3648 W Anthem Way Ste A100, Anthem, AZ 85086 Phone: 623-434-6444 Fax: 623-434-6448
Hannah Parrish, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 42201 N 41st Dr Ste 160, Anthem, AZ 85086 Phone: 480-360-8112
Kristen Lynn Stout, MSN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3648 W Anthem Way Ste A100, Anthem, AZ 85086 Phone: 623-434-6444
Pamela Fazekas, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3201 W Feather Sound Dr, Anthem, AZ 85086 Phone: 623-399-0023
Mrs. Nicole Renee Bishop, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 42104 N Venture Dr Ste D118, Anthem, AZ 85086 Phone: 602-312-9492
Jillian Brynn Goldney, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 41810 N Venture Dr Unit D136, Anthem, AZ 85086 Phone: 480-556-0446 Fax: 480-556-0447

Teresa A Gannon, NURSE PRACTITIONER - Medicare Nurse Practitioner in Anthem, AZ