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Amber R. Degitz

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133

PECOS Enrollment

This provider is enrolled in PECOS as AMBER DEGITZ.

Based on the most recent information from CMS, provider Amber R. Degitz is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1679814784
Provider Type
Individual
Full Name
Degitz, Amber R.
Credential
NP

Gender
Female
Sole Proprietor
No
Enumeration Date
3/14/2013
Last Updated
11/7/2016

Contact Information

Practice Location

7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133

(260) 436-8686

(260) 436-8585

Mailing Location

PO Box 2526, Fort Wayne, IN 46801-2526

(260) 436-8686

(260) 436-8585

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 71004359A Indiana

Provider Identifiers

ID	Description	Issuer
ID P01326889	Description Other	Issuer RAILROAD MEDICARE
ID 201161790	Description Medicaid	Issuer Unlisted Indiana
ID 000000807103	Description Other	Issuer ANTHEM

Amber R. Degitz

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

Preece, Billy Ray

Mccord, Geoffrey A.

Lee, Ford W.

Heckley, Susan E.

Schlatter, Andrew J.

Adams-Hayes, Susan M

Heath, Melanie J.

Blauvelt, Grant Michael

Price, Carrie B

Rodriguez, Laura L