Dr Jose Nellikappallil, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Fort Worth, Texas. His current practice location is
1500 S Main St, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at
(817) 702-8840.
Dr Jose Nellikappallil is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124777255.
Physician's Profile
Full Name | Dr Jose Nellikappallil |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1500 S Main St, Fort Worth, 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: 1124777255
- Provider Enumeration Date: 03/23/2022
- Last Update Date: 11/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698213791
- Enrollment ID: I20240821000111
Medical Identifiers
Medical identifiers for Dr Jose Nellikappallil such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124777255 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | V2180 (Texas) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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 Jose Nellikappallil allows following entities to bill medicare on his behalf.
Entity Name | Integrative Emergency Services Physician Group Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1285922542 PECOS PAC ID: 0749447936 Enrollment ID: O20120130000932 |
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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. Dr Jose Nellikappallil 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 Jose Nellikappallil, MD 1500 S Main St, Fort Worth, TX 76104-4917 Ph: (817) 702-8840 | Dr Jose Nellikappallil, MD 1500 S Main St, Fort Worth, TX 76104-4917 Ph: (817) 702-8840 |
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