Ms Amanda Forister, MS is a medicare enrolled "Behavior Analyst" provider in Jacksonville, Florida. Her current practice location is
12724 Gran Bay Pkwy W Ste 410, Jacksonville, Florida. You can reach out to her office (for appointments etc.) via phone at
(855) 832-6727.
Ms Amanda Forister is licensed to practice in Florida (license number MH24302) 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 1063914869.
Healthcare Provider's Profile
| Full Name | Ms Amanda Forister |
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| Gender | Female |
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| Speciality | Behavior Analyst |
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| Location | 12724 Gran Bay Pkwy W Ste 410, Jacksonville, Florida |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063914869
- Provider Enumeration Date: 03/07/2018
- Last Update Date: 11/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 3779810247
- Enrollment ID: I20240509001878
Medical Identifiers
Medical identifiers for Ms Amanda Forister such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063914869 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | PPC-1056 (Wyoming) | Secondary |
| 101YM0800X | Counselor - Mental Health | MH24302 (Florida) | Secondary |
| 101YM0800X | Counselor - Mental Health | LPC1828 (Wyoming) | Secondary |
| 103K00000X | Behavior Analyst | MH24302 (Florida) | 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. Ms Amanda Forister allows following entities to bill medicare on her behalf.
| Entity Name | Atlas Therapy Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073028494
PECOS PAC ID: 7315274883
Enrollment ID: O20190806002496 |
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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. Ms Amanda Forister 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 |
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Ms Amanda Forister, MS
319 Oak Fern Cir,
Ormond Beach, FL 32174-4875
Ph: (307) 363-2250 | Ms Amanda Forister, MS
12724 Gran Bay Pkwy W Ste 410,
Jacksonville, FL 32258-9486
Ph: (855) 832-6727 |
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