Carly Jessica Knobloch, PMHNP is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Bixby, Oklahoma. Her current practice location is
11911 S Memorial Dr, Bixby, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 943-3790.
Carly Jessica Knobloch is licensed to practice in Louisiana (license number RN150943) 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 1700454287.
Physician's Profile
| Full Name | Carly Jessica Knobloch |
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| Gender | Female |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 11911 S Memorial Dr, Bixby, Oklahoma |
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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: 1700454287
- Provider Enumeration Date: 06/11/2021
- Last Update Date: 12/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860871936
- Enrollment ID: I20220620002041
Medical Identifiers
Medical identifiers for Carly Jessica Knobloch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700454287 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | RN150943 (Louisiana) | 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. Carly Jessica Knobloch allows following entities to bill medicare on her behalf.
| Entity Name | Prophylaxis Healthcare Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538453923
PECOS PAC ID: 3072784289
Enrollment ID: O20110920000575 |
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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. Carly Jessica Knobloch 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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Carly Jessica Knobloch, PMHNP
Po Box 334,
Bixby, OK 74008-0334
Ph: (918) 943-3790 | Carly Jessica Knobloch, PMHNP
11911 S Memorial Dr,
Bixby, OK 74008-2030
Ph: (918) 943-3790 |
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