Grace Ayandibu, MD, MS, LPC is a medicare enrolled "Dermatology - Procedural Dermatology" provider in Wichita Falls, Texas. Her current practice location is
2637 Plaza Pkwy, Wichita Falls, Texas. You can reach out to her office (for appointments etc.) via phone at
(940) 239-9160.
Grace Ayandibu is licensed to practice in Texas (license number T9346) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023395928.
Healthcare Provider's Profile
Full Name | Grace Ayandibu |
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Gender | Female |
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Speciality | Dermatology - Procedural Dermatology |
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Location | 2637 Plaza Pkwy, Wichita Falls, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1023395928
- Provider Enumeration Date: 11/08/2011
- Last Update Date: 04/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 6103180138
- Enrollment ID: I20230228000455
Medical Identifiers
Medical identifiers for Grace Ayandibu such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023395928 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | 178007242 (Illinois) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
207NS0135X | Dermatology - Procedural Dermatology | T9346 (Texas) | Primary |
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. Grace Ayandibu allows following entities to bill medicare on her behalf.
Entity Name | All Skin Dermatology, Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760194443 PECOS PAC ID: 2668846742 Enrollment ID: O20230314000872 |
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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. Grace Ayandibu 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 |
Grace Ayandibu, MD, MS, LPC 2637 Plaza Pkwy, Wichita Falls, TX 76308-3889 Ph: (940) 666-3060 | Grace Ayandibu, MD, MS, LPC 2637 Plaza Pkwy, Wichita Falls, TX 76308-3889 Ph: (940) 239-9160 |
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