Courtney E Rose, DO is a medicare enrolled "Pediatrics" physician in Jacksonville, Texas. Her current practice location is
203 Nacogdoches St, Suite 275, Jacksonville, Texas. You can reach out to her office (for appointments etc.) via phone at
(309) 541-5472.
Courtney E Rose is licensed to practice in Texas (license number N9947) 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 1265727457.
Physician's Profile
Full Name | Courtney E Rose |
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Gender | Female |
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Speciality | Pediatrics |
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Location | 203 Nacogdoches St, Jacksonville, 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: 1265727457
- Provider Enumeration Date: 06/15/2011
- Last Update Date: 07/30/2012
Medicare PECOS Information:
- PECOS PAC ID: 1153591870
- Enrollment ID: I20110906000717
Medical Identifiers
Medical identifiers for Courtney E Rose such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1265727457 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | N9947 (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. Courtney E Rose allows following entities to bill medicare on her behalf.
Entity Name | Etmc Physician Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609382662 PECOS PAC ID: 4486915600 Enrollment ID: O20180305002106 |
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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. Courtney E Rose 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 |
Courtney E Rose, DO 203 Nacogdoches St, Suite 275, Jacksonville, TX 75766-2462 Ph: (309) 541-5472 | Courtney E Rose, DO 203 Nacogdoches St, Suite 275, Jacksonville, TX 75766-2462 Ph: (309) 541-5472 |
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