Whitnie Elizabeth Petzoldt, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Hermitage, Tennessee. Her current practice location is
3613 Caledon Ct, Hermitage, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(573) 768-1848.
Whitnie Elizabeth Petzoldt is licensed to practice in Michigan (license number 4704394799) 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 1528734183.
Provider's Profile
| Full Name | Whitnie Elizabeth Petzoldt |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 3613 Caledon Ct, Hermitage, Tennessee |
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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: 1528734183
- Provider Enumeration Date: 08/23/2021
- Last Update Date: 10/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 3971973322
- Enrollment ID: I20221230000664
Medical Identifiers
Medical identifiers for Whitnie Elizabeth Petzoldt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528734183 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 4704394799 (Michigan) | Primary |
| 207L00000X | Anesthesiology | 4704394799 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 2018007896 (Missouri) | Secondary |
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. Whitnie Elizabeth Petzoldt allows following entities to bill medicare on her behalf.
| Entity Name | Superior Anesthetists Associates Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831144518
PECOS PAC ID: 5890784987
Enrollment ID: O20040512000785 |
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| Entity Name | Asa Staffing Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114378981
PECOS PAC ID: 3971898644
Enrollment ID: O20160818002713 |
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| Entity Name | Northstar Anesthesia Of Michigan Iii Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972126209
PECOS PAC ID: 7911325469
Enrollment ID: O20200915001990 |
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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. Whitnie Elizabeth Petzoldt 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 |
|---|
Whitnie Elizabeth Petzoldt,
3613 Caledon Ct,
Hermitage, TN 37076-4451
Ph: (573) 768-1848 | Whitnie Elizabeth Petzoldt,
3613 Caledon Ct,
Hermitage, TN 37076-4451
Ph: (573) 768-1848 |
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