Shraddha Jai Khokhal, is a medicare enrolled "Nurse Practitioner" physician in Greensboro, North Carolina. Her current practice location is
3402 Battleground Ave, Greensboro, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(336) 883-0029.
Shraddha Jai Khokhal is licensed to practice in North Carolina (license number 5019413) 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 1215707096.
Physician's Profile
| Full Name | Shraddha Jai Khokhal |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 3402 Battleground Ave, Greensboro, North Carolina |
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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: 1215707096
- Provider Enumeration Date: 01/03/2024
- Last Update Date: 07/19/2024
Medicare PECOS Information:
- PECOS PAC ID: 6608211909
- Enrollment ID: I20240227000322
Medical Identifiers
Medical identifiers for Shraddha Jai Khokhal such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215707096 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208VP0000X | Pain Medicine - Pain Medicine | 5019413 (North Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 5019413 (North Carolina) | Secondary |
| 363L00000X | Nurse Practitioner | 5019413 (North Carolina) | 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. Shraddha Jai Khokhal allows following entities to bill medicare on her behalf.
| Entity Name | Bethany Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952404188
PECOS PAC ID: 4486614575
Enrollment ID: O20041013000729 |
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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. Shraddha Jai Khokhal 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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Shraddha Jai Khokhal,
645 N Main St,
High Point, NC 27260-5017
Ph: (336) 883-0029 | Shraddha Jai Khokhal,
3402 Battleground Ave,
Greensboro, NC 27410-2578
Ph: (336) 883-0029 |
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