Dr Alexandra Nicole Theisen, MD, MS in Little Rock, AR

Dr Alexandra Nicole Theisen, MD, MS is a medicare enrolled "Pediatrics - Pediatric Rheumatology" physician in Little Rock, Arkansas. Her current practice location is 1 Childrens Way # 512, Little Rock, Arkansas. You can reach out to her office (for appointments etc.) via phone at (501) 364-1100.

Dr Alexandra Nicole Theisen is licensed to practice in Arkansas (license number E-17953) 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 1225486160.

Contact Information

	Dr Alexandra Nicole Theisen, MD, MS
	1 Childrens Way # 512, Little Rock, AR 72202-3500
	(501) 364-1100
	(501) 364-4052

Map and Direction

Physician's Profile

Full Name	Dr Alexandra Nicole Theisen
Gender	Female
Speciality	Pediatrics - Pediatric Rheumatology
Location	1 Childrens Way # 512, Little Rock, Arkansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225486160
Provider Enumeration Date: 06/01/2016
Last Update Date: 07/02/2024

Medicare PECOS Information:

PECOS PAC ID: 5991096075
Enrollment ID: I20220728001420

Medical Identifiers

Medical identifiers for Dr Alexandra Nicole Theisen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225486160	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	E-17953 (Arkansas)	Secondary
208000000X	Pediatrics	2022019876 (Missouri)	Secondary
2080P0216X	Pediatrics - Pediatric Rheumatology	2022019876 (Missouri)	Secondary
2080P0216X	Pediatrics - Pediatric Rheumatology	E-17953 (Arkansas)	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. Dr Alexandra Nicole Theisen allows following entities to bill medicare on her behalf.

Entity Name	Ssm Cardinal Glennon Children's Hospital
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174577670 PECOS PAC ID: 7012828163 Enrollment ID: O20031231000604

Entity Name	Ssm Health Care Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306589544 PECOS PAC ID: 0143608372 Enrollment ID: O20220531002655

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. Dr Alexandra Nicole Theisen 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
Dr Alexandra Nicole Theisen, MD, MS 1 Childrens Way # 653, Little Rock, AR 72202-3500 Ph: (501) 364-1100	Dr Alexandra Nicole Theisen, MD, MS 1 Childrens Way # 512, Little Rock, AR 72202-3500 Ph: (501) 364-1100

Reviews and Comments

Pediatrics Doctors in Little Rock, AR

Dr. Michael William Bishop, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way Fl Wing1, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-4082
Amber Michele Morse, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-16, Little Rock, AR 72202 Phone: 501-364-1050 Fax: 501-364-6931
Dustin Edward Williford, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-8, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-2963
Kristyn N Jeffries, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-1, Little Rock, AR 72202 Phone: 501-364-5262 Fax: 501-364-3418
Thanh Thanh Dai, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-24a, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-4082
Indirapriya Darshini Avulakunta, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-1, Little Rock, AR 72202 Phone: 501-364-5262 Fax: 501-364-3418
Abdelrahman Masri, Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Childrens Way # 512-1, Little Rock, AR 72202 Phone: 501-364-1100 Fax: 501-364-4082

Dr Alexandra Nicole Theisen, MD, MS - Medicare Pediatrics in Little Rock, AR