Tequila Breyonda Petty, OT in Hickory, NC - Medicare Occupational Therapist Provider

Tequila Breyonda Petty, OT is a medicare enrolled "Occupational Therapist" provider in Hickory, North Carolina. Her current practice location is 16 2nd St Nw, Hickory, North Carolina. You can reach out to her office (for appointments etc.) via phone at (828) 358-0976.

Tequila Breyonda Petty is licensed to practice in North Carolina (license number 16408) 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 1417723768.

Contact Information

	Tequila Breyonda Petty, OT
	16 2nd St Nw, Hickory, NC 28601-6105
	(828) 358-0976
	(828) 838-1057

Map and Direction

Healthcare Provider's Profile

Full Name	Tequila Breyonda Petty
Gender	Female
Speciality	Occupational Therapist
Location	16 2nd St Nw, Hickory, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417723768
Provider Enumeration Date: 11/28/2023
Last Update Date: 05/30/2024

Medicare PECOS Information:

PECOS PAC ID: 3375995798
Enrollment ID: I20240122000521

Medical Identifiers

Medical identifiers for Tequila Breyonda Petty such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417723768	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	16408 (North Carolina)	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. Tequila Breyonda Petty allows following entities to bill medicare on her behalf.

Provider Name	Kidology Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1730591991 PECOS PAC ID: 3476943887 Enrollment ID: O20211129001112

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. Tequila Breyonda Petty 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
Tequila Breyonda Petty, OT Po Box 749, Belmont, NC 28012-0749 Ph: () -	Tequila Breyonda Petty, OT 16 2nd St Nw, Hickory, NC 28601-6105 Ph: (828) 358-0976

Reviews and Comments

Occupational Therapist in Hickory, NC

Jennifer Fisher, Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 3034 N Center St Ste A, Hickory, NC 28601 Phone: 828-256-4313
Erin Hilker, Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 3031 Tate Blvd Se, Hickory, NC 28602 Phone: 828-322-3343
Kayla Cook, MOT OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1899 Tate Blvd Se Ste 2106, Hickory, NC 28602 Phone: 828-358-0976 Fax: 828-838-1057
Dr. Ellen E Sparks, OTD, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1087 13th St Se, Hickory, NC 28602 Phone: 828-267-1688
Stacey Mullis, OTR, ATP Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 431 9th St Nw, Hickory, NC 28601 Phone: 828-238-2130
Lindsey Carole Robins, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1087 13th St Se, Hickory, NC 28602 Phone: 828-267-1688 Fax: 828-267-1690
John Robert Maney, OT Occupational Therapist Medicare: Accepting Medicare Assignments Practice Location: 2165 Medical Park Dr, Hickory, NC 28602 Phone: 828-324-2800 Fax: 828-294-9160

Tequila Breyonda Petty, OT - Medicare Occupational Therapist in Hickory, NC