Medical Practice in Pendleton, IN - Medicare Clinic/Center

Medical Practice is a medicare enrolled primary clinic (Clinic/center - Primary Care) in Pendleton, Indiana. The current practice location for Medical Practice is 8391 S Shady Trail Dr, Pendleton, Indiana. For appointments, you can reach them via phone at (317) 507-2395. The mailing address for Medical Practice is 8391 S Shady Trail Dr, Pendleton, Indiana and phone number is (317) 743-0009.

Medical Practice is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1437622701. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (317) 507-2395.

Contact Information

	Medical Practice
	8391 S Shady Trail Dr Pendleton IN 46064-8652
	(317) 507-2395
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name	Medical Practice
Speciality	Clinic/Center
Location	8391 S Shady Trail Dr, Pendleton, Indiana
Authorized Official Name and Position	Taris D Gonzalez (NURSE PRACTITIONER/OWNER)
Authorized Official Contact	3177430009
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Medical Practice 8391 S Shady Trail Dr Pendleton IN 46064-8652 Ph: (317) 743-0009	Medical Practice 8391 S Shady Trail Dr Pendleton IN 46064-8652 Ph: (317) 507-2395

NPI Details:

NPI Number	1437622701
Provider Enumeration Date	01/09/2019
Last Update Date	01/30/2020

Medicare PECOS Information:

Medicare PECOS PAC ID	7113267022
Medicare Enrollment ID	O20190312002841

Medical Identifiers

Medical identifiers for Medical Practice such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1437622701	NPI	-	NPPES
1821290743	Medicaid	IN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QP2300X	Clinic/center - Primary Care	(* (Not Available))	Primary
261QR1300X	Clinic/center - Rural Health	(* (Not Available))	Secondary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medical Practice acts as a billing entity for following providers:

Provider Name	Taris D Gonzalez
Provider Type	Practitioner - Nurse Practitioner
Provider Identifiers	NPI Number: 1821290743 PECOS PAC ID: 1153595491 Enrollment ID: I20111122000526

Reviews and Comments

Clinic/Center in Pendleton, IN

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Pharmobile Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8975 S 800 W, Pendleton, IN 46064 Phone: 317-485-3117 Fax: 888-322-9457

Medical Practice - Medicare Primary Care in Pendleton, IN