Renuva Back And Pain Center is a medicare enrolled "Nurse Practitioner" provider in Overland Park, Kansas. Their current practice location is
4400 College Blvd Ste 150, Overland Park, Kansas. You can reach out to their office (for appointments etc.) via phone at
(913) 667-2298.
Renuva Back And Pain Center is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Renuva Back And Pain Center
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 1801155486.
Healthcare Provider's Profile
| Full Name | Renuva Back And Pain Center |
|---|
| Type | Facility |
|---|
| Speciality | Nurse Practitioner |
|---|
| Location | 4400 College Blvd Ste 150, Overland Park, Kansas |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1801155486
- Provider Enumeration Date: 05/16/2012
- Last Update Date: 12/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 7517224835
- Enrollment ID: O20171121003316
Medical Identifiers
Medical identifiers for Renuva Back And Pain Center such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1801155486 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 363L00000X | Nurse Practitioner | (* (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.
Renuva Back And Pain Center acts as a billing entity for following providers:
| Provider Name | Matthew R Metcalf |
|---|
| Provider Type | Practitioner - Chiropractic |
|---|
| Provider Identifiers | NPI Number: 1609898048
PECOS PAC ID: 4183665748
Enrollment ID: I20050513000655 |
|---|
| Provider Name | Kelly Gonzalez |
|---|
| Provider Type | Practitioner - Nurse Practitioner |
|---|
| Provider Identifiers | NPI Number: 1295127363
PECOS PAC ID: 8921326430
Enrollment ID: I20200422000404 |
|---|
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. Renuva Back And Pain Center 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 |
|---|
Renuva Back And Pain Center
4400 College Blvd Ste 150,
Overland Park, KS 66211-2326
Ph: (913) 667-2298 | Renuva Back And Pain Center
4400 College Blvd Ste 150,
Overland Park, KS 66211-2326
Ph: (913) 667-2298 |
Reviews and Comments