Timothy R Penniston, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Overgaard, Arizona. He graduated from nursing school in 2001 and has 23 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Summit Healthcare Medical Associates and his current practice location is
2352 Quarter Horse Trl, Overgaard, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 535-3616.
Timothy R Penniston is licensed to practice in Arizona (license number AP3433) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1144243692.
Provider's Profile
| Full Name | Timothy R Penniston |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 23 Years |
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| Location | 2352 Quarter Horse Trl, Overgaard, Arizona |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Timothy R Penniston graduated from nursing school in 2001
NPI Data:
- NPI Number: 1144243692
- Provider Enumeration Date: 07/25/2006
- Last Update Date: 02/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 8729035472
- Enrollment ID: I20090928000360
Medical Identifiers
Medical identifiers for Timothy R Penniston such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144243692 | NPI | - | NPPES |
| 453927 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | AP3433 (Arizona) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Summit Healthcare Medical Associates | 8729205737 | 79 |
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. Timothy R Penniston allows following entities to bill medicare on his behalf.
| Entity Name | Mariposa Community Health Center, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1417985474
PECOS PAC ID: 8123926326
Enrollment ID: O20031226000065 |
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| Entity Name | Summit Healthcare Medical Associates |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467878108
PECOS PAC ID: 8729205737
Enrollment ID: O20140815000931 |
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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. Timothy R Penniston 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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Timothy R Penniston, FNP-C
825 N Grand Ave Ste 100,
Nogales, AZ 85621-1061
Ph: (520) 281-1550 | Timothy R Penniston, FNP-C
2352 Quarter Horse Trl,
Overgaard, AZ 85933-5319
Ph: (928) 535-3616 |
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