Jill Crossgrove-murillo, RD is a medicare enrolled "Dietitian, Registered" provider in Wauseon, Ohio. Her current practice location is
725 S Shoop Ave, Wauseon, Ohio. You can reach out to her office (for appointments etc.) via phone at
(419) 330-2772.
Jill Crossgrove-murillo is licensed to practice in Ohio (license number LD4323) 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 1679219984.
Healthcare Provider's Profile
| Full Name | Jill Crossgrove-murillo |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 725 S Shoop Ave, Wauseon, Ohio |
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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: 1679219984
- Provider Enumeration Date: 05/10/2022
- Last Update Date: 05/10/2022
Medicare PECOS Information:
- PECOS PAC ID: 2961882170
- Enrollment ID: I20221118002006
Medical Identifiers
Medical identifiers for Jill Crossgrove-murillo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1679219984 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | LD4323 (Ohio) | 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. Jill Crossgrove-murillo allows following entities to bill medicare on her behalf.
| Provider Name | Fchc Medical Care, Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1598821175
PECOS PAC ID: 8022018704
Enrollment ID: O20070103000005 |
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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. Jill Crossgrove-murillo 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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Jill Crossgrove-murillo, RD
725 S Shoop Ave,
Wauseon, OH 43567-1702
Ph: (419) 330-2772 | Jill Crossgrove-murillo, RD
725 S Shoop Ave,
Wauseon, OH 43567-1702
Ph: (419) 330-2772 |
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