Ms Cynthia K Green, ED DIETITIAN is a medicare enrolled "Dietitian, Registered" provider in Gonzales, Texas. Her current practice location is
1110 N Sarah Dewitt Dr, Gonzales, Texas. You can reach out to her office (for appointments etc.) via phone at
(830) 672-7581.
Ms Cynthia K Green is licensed to practice in Texas (license number 862948) 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 1568565497.
Healthcare Provider's Profile
| Full Name | Ms Cynthia K Green |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 1110 N Sarah Dewitt Dr, Gonzales, Texas |
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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: 1568565497
- Provider Enumeration Date: 09/06/2006
- Last Update Date: 12/28/2016
Medicare PECOS Information:
- PECOS PAC ID: 8628393238
- Enrollment ID: I20150202001058
Medical Identifiers
Medical identifiers for Ms Cynthia K Green such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568565497 | NPI | - | NPPES |
| 3460982 | Medicaid | TX | |
| 00L70B | Other | TX | MEDICARE GROUP NUMBER |
| 862948 | Other | TX | DIETETIC REGISTRATION |
| DT05451 | Other | TX | LICENSED DIETITIAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 133V00000X | Dietitian, Registered | 862948 (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. Ms Cynthia K Green allows following entities to bill medicare on her behalf.
| Provider Name | Gonzales Healthcare Systems |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1013916287
PECOS PAC ID: 8527963776
Enrollment ID: O20040316001074 |
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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 Cynthia K Green 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 |
|---|
Ms Cynthia K Green, ED DIETITIAN
1110 N Sarah Dewitt Dr,
Gonzales, TX 78629-3311
Ph: (830) 672-7581 | Ms Cynthia K Green, ED DIETITIAN
1110 N Sarah Dewitt Dr,
Gonzales, TX 78629-3311
Ph: (830) 672-7581 |
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