Catherine Petzinger Deshazo, DO - Medicare General Surgery in Olive Branch, MS

Catherine Petzinger Deshazo, DO is a medicare enrolled "Surgery" physician in Olive Branch, Mississippi. She went to Midwestern University, Chicago College Of Osteopathic Med and graduated in 2014 and has 10 years of diverse experience with area of expertise as General Surgery. She is a member of the group practice Bolivar Physician Practices Llc and her current practice location is 5480 Goodman Rd, Olive Branch, Mississippi. You can reach out to her office (for appointments etc.) via phone at (662) 893-9815.

Catherine Petzinger Deshazo is licensed to practice in Mississippi (license number 26737) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1962822692.

Contact Information

Catherine Petzinger Deshazo, DO
5480 Goodman Rd,
Olive Branch, MS 38654-7902
(662) 893-9815
(662) 893-9888



Physician's Profile

Full NameCatherine Petzinger Deshazo
GenderFemale
SpecialityGeneral Surgery
Experience10 Years
Location5480 Goodman Rd, Olive Branch, Mississippi
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Catherine Petzinger Deshazo attended and graduated from Midwestern University, Chicago College Of Osteopathic Med in 2014
  NPI Data:
  • NPI Number: 1962822692
  • Provider Enumeration Date: 04/21/2014
  • Last Update Date: 11/30/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 1951696566
  • Enrollment ID: I20190911000573

Medical Identifiers

Medical identifiers for Catherine Petzinger Deshazo such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1962822692NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208600000XSurgery 26737 (Mississippi)Primary
208600000XSurgery 5101020893 (Michigan)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Bolivar Medical CenterCleveland, MSHospital
Methodist Healthcare - Olive Branch HospitalOlive branch, MSHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Bolivar Physician Practices Llc630599589516

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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. Catherine Petzinger Deshazo allows following entities to bill medicare on her behalf.
Entity NameBolivar Physician Practices Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063659530
PECOS PAC ID: 6305995895
Enrollment ID: O20090512000274

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Entity NameSpg Ii Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255602587
PECOS PAC ID: 7012177132
Enrollment ID: O20120515000546

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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. Catherine Petzinger Deshazo 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 AddressPractice Location Address
Catherine Petzinger Deshazo, DO
1211 Union Ave Ste 330,
Memphis, TN 38104-6655

Ph: (901) 478-0966
Catherine Petzinger Deshazo, DO
5480 Goodman Rd,
Olive Branch, MS 38654-7902

Ph: (662) 893-9815

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Surgery Doctors in Olive Branch, MS

Dr. Michael E. Foster, M.D.
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 5036 Goodman Rd, Suite #116, Olive Branch, MS 38654
Phone: 662-420-7061    Fax: 662-420-7583
Dr. Thomas Bass Beasley, MD
Surgery
Medicare: Accepting Medicare Assignments
Practice Location: 5480 Goodman Rd, Suite 2, Olive Branch, MS 38654
Phone: 662-893-9815    Fax: 662-893-9888

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