Tyanna Bergeron, NP in Fulton, NY - Medicare Nurse Practitioner

Tyanna Bergeron, NP is a medicare enrolled "Nurse Practitioner" in Fulton, New York. Her current practice location is 522 S 4th St, Fulton, New York. You can reach out to her office (for appointments etc.) via phone at (155) 923-9303.

Tyanna Bergeron is licensed to practice in New York (license number F03190068) 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 1891257630.

Contact Information

	Tyanna Bergeron, NP
	522 S 4th St, Fulton, NY 13069-2946
	(155) 923-9303
	Not Available

Map and Direction

Provider's Profile

Full Name	Tyanna Bergeron
Gender	Female
Speciality	Nurse Practitioner
Location	522 S 4th St, Fulton, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1891257630
Provider Enumeration Date: 04/02/2019
Last Update Date: 06/11/2019

Medicare PECOS Information:

PECOS PAC ID: 6901149970
Enrollment ID: I20190514001908

Medical Identifiers

Medical identifiers for Tyanna Bergeron such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1891257630	NPI	-	NPPES
14421177	Other		CAQH

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	F03190068 (New York)	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. Tyanna Bergeron allows following entities to bill medicare on her behalf.

Entity Name	Pons Physician Services Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457732554 PECOS PAC ID: 9931416187 Enrollment ID: O20150921001165

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. Tyanna Bergeron 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
Tyanna Bergeron, NP 110 W 6th St, Oswego, NY 13126-2507 Ph: (315) 349-5511	Tyanna Bergeron, NP 522 S 4th St, Fulton, NY 13069-2946 Ph: (155) 923-9303

Reviews and Comments

Nurse Practitioner Nurses in Fulton, NY

Mrs. Rebecca Dottolo, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 510 S 4th St, Fulton, NY 13069 Phone: 315-592-3500
Samantha Goutermout, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 522 S 4th St, Fulton, NY 13069 Phone: 315-592-3930 Fax: 315-592-3932
Mrs. Cheryl Susan Martin-schroeder, M.S.N.,P.N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 63 S 1st St, Fulton, NY 13069 Phone: 315-598-6785 Fax: 315-592-3571
Shannon M Woods, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 98 N 2nd St, Fulton, NY 13069 Phone: 315-326-3555
Anthony Bryant, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 510 S 4th St Ste 600, Fulton, NY 13069 Phone: 315-598-4790 Fax: 315-593-6195
Mrs. Joanne Lomber, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 941 S 1st St, Fulton, NY 13069 Phone: 315-593-1729
Ms. Claire Ann Vacca, N,P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 21 N 2nd St, Fulton, NY 13069 Phone: 315-598-7105 Fax: 315-598-4857

Tyanna Bergeron, NP - Medicare Nurse Practitioner in Fulton, NY