Ernest Samuel Holmes Iv, MD is a medicare enrolled "Pediatrics" physician in Neosho, Missouri. His current practice location is
336 S Jefferson St, Neosho, Missouri. You can reach out to his office (for appointments etc.) via phone at
(417) 451-0778.
Ernest Samuel Holmes Iv is licensed to practice in Missouri (license number 115096) 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 1316977804.
Physician's Profile
| Full Name | Ernest Samuel Holmes Iv |
|---|
| Gender | Male |
|---|
| Speciality | Pediatrics |
|---|
| Location | 336 S Jefferson St, Neosho, Missouri |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1316977804
- Provider Enumeration Date: 07/03/2006
- Last Update Date: 02/17/2011
Medicare PECOS Information:
- PECOS PAC ID: 3173794336
- Enrollment ID: I20110919000745
Medical Identifiers
Medical identifiers for Ernest Samuel Holmes Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1316977804 | NPI | - | NPPES |
| 100149160A | Medicaid | OK | |
| 100317780A | Medicaid | KS | |
| 203756804 | Medicaid | MO | |
| 115234 | Other | MO | ANTHEM |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 115096 (Missouri) | 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. Ernest Samuel Holmes Iv allows following entities to bill medicare on his behalf.
| Entity Name | Freeman Neosho Hospital |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1083045686
PECOS PAC ID: 4284624552
Enrollment ID: O20040729000101 |
|---|
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. Ernest Samuel Holmes Iv 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 |
|---|
Ernest Samuel Holmes Iv, MD
Po Box 3810,
Joplin, MO 64803
Ph: (417) 451-0778 | Ernest Samuel Holmes Iv, MD
336 S Jefferson St,
Neosho, MO 64850-1769
Ph: (417) 451-0778 |
Reviews and Comments