Melissa Marie Fofana, FNP-C is a medicare enrolled "Nurse Practitioner - Family" physician in Fargo, North Dakota. Her current practice location is
1701 38th St S Ste 101, Fargo, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 356-1500.
Melissa Marie Fofana is licensed to practice in North Dakota (license number R38049) 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 1053026070.
Physician's Profile
| Full Name | Melissa Marie Fofana |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 1701 38th St S Ste 101, Fargo, North Dakota |
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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: 1053026070
- Provider Enumeration Date: 01/16/2023
- Last Update Date: 04/05/2023
Medicare PECOS Information:
- PECOS PAC ID: 4385018605
- Enrollment ID: I20230328000364
Medical Identifiers
Medical identifiers for Melissa Marie Fofana such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053026070 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | R38049 (North Dakota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 9983 (Minnesota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | R38049 (North Dakota) | 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. Melissa Marie Fofana allows following entities to bill medicare on her behalf.
| Entity Name | Red River Valley Health Care Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053870253
PECOS PAC ID: 8022340637
Enrollment ID: O20191209001242 |
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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. Melissa Marie Fofana 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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Melissa Marie Fofana, FNP-C
1701 38th St S Ste 101,
Fargo, ND 58103-4499
Ph: (701) 356-1500 | Melissa Marie Fofana, FNP-C
1701 38th St S Ste 101,
Fargo, ND 58103-4499
Ph: (701) 356-1500 |
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