Refined Form Physical Therapy, Pllc is a medicare enrolled "Physical Therapist" provider in Crestone, Colorado. Their current practice location is
3704 Carefree Way, Crestone, Colorado. You can reach out to their office (for appointments etc.) via phone at
(360) 713-7938.
Refined Form Physical Therapy, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Refined Form Physical Therapy, Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1619601978.
Healthcare Provider's Profile
Full Name | Refined Form Physical Therapy, Pllc |
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Type | Facility |
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Speciality | Physical Therapist |
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Location | 3704 Carefree Way, Crestone, Colorado |
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Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1619601978
- Provider Enumeration Date: 07/13/2022
- Last Update Date: 03/22/2023
Medicare PECOS Information:
- PECOS PAC ID: 9335522622
- Enrollment ID: O20220819000296
Medical Identifiers
Medical identifiers for Refined Form Physical Therapy, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1619601978 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Refined Form Physical Therapy, Pllc acts as a billing entity for following providers:
Provider Name | Jennifer Elaine Walkowski |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
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Provider Identifiers | NPI Number: 1316395619 PECOS PAC ID: 9739473570 Enrollment ID: I20220819000288 |
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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. Refined Form Physical Therapy, Pllc 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 |
Refined Form Physical Therapy, Pllc Po Box 404, Crestone, CO 81131-0404 Ph: (719) 204-3434 | Refined Form Physical Therapy, Pllc 3704 Carefree Way, Crestone, CO 81131-0404 Ph: (360) 713-7938 |
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