Ms Joann Modupe Bolude, MD is a medicare enrolled "General Practice" physician in Cotulla, Texas. Her current practice location is
105 S. Stewart, Cotulla, Texas. You can reach out to her office (for appointments etc.) via phone at
(830) 879-3047.
Ms Joann Modupe Bolude is licensed to practice in Texas (license number Q5763) 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 1255666335.
Physician's Profile
Full Name | Ms Joann Modupe Bolude |
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Gender | Female |
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Speciality | General Practice |
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Location | 105 S. Stewart, Cotulla, 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: 1255666335
- Provider Enumeration Date: 10/07/2009
- Last Update Date: 09/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 8022399013
- Enrollment ID: I20170105002124
Medical Identifiers
Medical identifiers for Ms Joann Modupe Bolude such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255666335 | NPI | - | NPPES |
365574801 | Medicaid | TX | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | Q5763 (Texas) | Secondary |
208D00000X | General Practice | Q5763 (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. Ms Joann Modupe Bolude allows following entities to bill medicare on her behalf.
Entity Name | Open Arms Healthcare Of Texas Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1639656325 PECOS PAC ID: 9436400579 Enrollment ID: O20180928000718 |
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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. Ms Joann Modupe Bolude 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 |
Ms Joann Modupe Bolude, MD 105 S. Stewart, Cotulla, TX 78014-1013 Ph: (830) 879-3047 | Ms Joann Modupe Bolude, MD 105 S. Stewart, Cotulla, TX 78014-7801 Ph: (830) 879-3047 |
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