Brenden G Tully, PA in Ashtabula, OH - Medicare Physician Assistant

Brenden G Tully, PA is a medicare enrolled "Physician Assistant" in Ashtabula, Ohio. His current practice location is 2420 Lake Ave, Ashtabula, Ohio. You can reach out to his office (for appointments etc.) via phone at (440) 997-2262.

Brenden G Tully is licensed to practice in Ohio (license number 50.008422RX) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1720765969.

Contact Information

	Brenden G Tully, PA
	2420 Lake Ave, Ashtabula, OH 44004-4954
	(440) 997-2262
	Not Available

Provider's Profile

Full Name	Brenden G Tully
Gender	Male
Speciality	Physician Assistant
Location	2420 Lake Ave, Ashtabula, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720765969
Provider Enumeration Date: 06/29/2023
Last Update Date: 10/10/2023

Medicare PECOS Information:

PECOS PAC ID: 3971959149
Enrollment ID: I20231024002114

Medical Identifiers

Medical identifiers for Brenden G Tully such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720765969	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	50.008422RX (Ohio)	Primary

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. Brenden G Tully 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
Brenden G Tully, PA 411 Castle Rock Rd, Brookfield, OH 44403-8603 Ph: (330) 413-7913	Brenden G Tully, PA 2420 Lake Ave, Ashtabula, OH 44004-4954 Ph: (440) 997-2262

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Physician Assistant Nurses in Ashtabula, OH

Michell Mcdiffett, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4200 Park Ave, Ashtabula, OH 44004 Phone: 216-280-4363
Mallory Shellenberger, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 4009 Shi Mar Dr, Ashtabula, OH 44004 Phone: 440-813-1579
Mrs. Samantha Rae Meabon, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 416 W 27th St, Ashtabula, OH 44004 Phone: 440-997-5427
Joseph Michael Delatore, PA Physician Assistant Medicare: Medicare Enrolled Practice Location: 2420 Lake Ave, Ashtabula, OH 44004 Phone: 440-997-2262
Beth Zanko, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2422 Lake Ave, Ashtabula, OH 44004 Phone: 440-997-6731
Tatyana N Kuvshinikov, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 3315 N Ridge Rd E Ste 700a, Ashtabula, OH 44004 Phone: 440-484-2130
Andrea M Swartout, Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4211 Birchwood Ave, Ashtabula, OH 44004 Phone: 440-993-1267

Brenden G Tully, PA - Medicare Physician Assistant in Ashtabula, OH