Evelyn Villarreal Laclede, PT, DPT in Jacksonville, NC - Medicare Physical Therapist Provider

Evelyn Villarreal Laclede, PT, DPT is a medicare enrolled "Physical Therapist" provider in Jacksonville, North Carolina. Her current practice location is 2457 Gum Branch Rd # 600-800, Jacksonville, North Carolina. You can reach out to her office (for appointments etc.) via phone at (252) 228-4643.

Evelyn Villarreal Laclede is licensed to practice in North Carolina (license number CP029624T) 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 1326645375.

Contact Information

	Evelyn Villarreal Laclede, PT, DPT
	2457 Gum Branch Rd # 600-800, Jacksonville, NC 28540-4008
	(252) 228-4643
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Evelyn Villarreal Laclede
Gender	Female
Speciality	Physical Therapist
Location	2457 Gum Branch Rd # 600-800, Jacksonville, 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: 1326645375
Provider Enumeration Date: 10/02/2020
Last Update Date: 03/10/2024

Medicare PECOS Information:

PECOS PAC ID: 7416377551
Enrollment ID: I20201012001821

Medical Identifiers

Medical identifiers for Evelyn Villarreal Laclede such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326645375	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	1337128 (Texas)	Secondary
225100000X	Physical Therapist	PT61393182 (Washington)	Secondary
225100000X	Physical Therapist	CP029624T (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. Evelyn Villarreal Laclede allows following entities to bill medicare on her behalf.

Provider Name	Optimal Physical Therapy Solutions, Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1497058689 PECOS PAC ID: 3072791532 Enrollment ID: O20110705000089

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. Evelyn Villarreal Laclede 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
Evelyn Villarreal Laclede, PT, DPT 2457 Gum Branch Rd # 600-800, Jacksonville, NC 28540-4008 Ph: () -	Evelyn Villarreal Laclede, PT, DPT 2457 Gum Branch Rd # 600-800, Jacksonville, NC 28540-4008 Ph: (252) 228-4643

Reviews and Comments

Physical Therapist in Jacksonville, NC

Erin M Ryan, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 2453 Gum Branch Rd Ste 600, Jacksonville, NC 28540 Phone: 910-353-9800 Fax: 910-455-2083
Kelsey Aldi, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 122 Branchwood Shopping Ctr, Jacksonville, NC 28546 Phone: 910-938-7555
Dr. Taylor Chadwick Bryan, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2453 Gum Branch Rd Ste 600, Jacksonville, NC 28540 Phone: 910-353-9800 Fax: 910-455-2083
Mr. Frank J Mikloucich Jr., D.P.T. Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 3060 Henderson Dr, Jacksonville, NC 28546 Phone: 910-346-3151 Fax: 910-346-2975
Heather Koopman, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 2000 Brabham Ave Ste 100, Jacksonville, NC 28546 Phone: 910-332-3800 Fax: 910-251-0421
Darrin Eugene Madole, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 122 Branchwood Shopping Ctr, Jacksonville, NC 28546 Phone: 910-938-7555 Fax: 910-938-7544
Jose Luis Dejesus, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 122 Branchwood Shopping Ctr, Jacksonville, NC 28546 Phone: 910-938-7555 Fax: 910-938-7544

Evelyn Villarreal Laclede, PT, DPT - Medicare Physical Therapist in Jacksonville, NC