Ms Audrey Susan Petzold, OTR/L is a medicare enrolled "Occupational Therapist - Pediatrics" provider in Placitas, New Mexico. Her current practice location is
32 Cuchilla De Lupe Rd, Placitas, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(505) 867-5203.
Ms Audrey Susan Petzold is licensed to practice in New Mexico (license number 1181) 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 1700218526.
Healthcare Provider's Profile
Full Name | Ms Audrey Susan Petzold |
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Gender | Female |
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Speciality | Occupational Therapist - Pediatrics |
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Location | 32 Cuchilla De Lupe Rd, Placitas, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1700218526
- Provider Enumeration Date: 08/02/2013
- Last Update Date: 08/02/2013
Medicare PECOS Information:
- PECOS PAC ID: 2961878814
- Enrollment ID: I20221018000183
Medical Identifiers
Medical identifiers for Ms Audrey Susan Petzold such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1700218526 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225X00000X | Occupational Therapist | 1181 (New Mexico) | Secondary |
225XM0800X | Occupational Therapist - Mental Health | 1181 (New Mexico) | Secondary |
225XP0200X | Occupational Therapist - Pediatrics | 1181 (New Mexico) | 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. Ms Audrey Susan Petzold allows following entities to bill medicare on her behalf.
Provider Name | Presbyterian Ear Institute |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1316029945 PECOS PAC ID: 3779533138 Enrollment ID: O20050512000684 |
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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. Ms Audrey Susan Petzold 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 |
Ms Audrey Susan Petzold, OTR/L 32 Cuchilla De Lupe Rd, Placitas, NM 87043-8716 Ph: (505) 867-5203 | Ms Audrey Susan Petzold, OTR/L 32 Cuchilla De Lupe Rd, Placitas, NM 87043-8716 Ph: (505) 867-5203 |
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