Alisa Beth Fajkus, CNM is a medicare enrolled "Advanced Practice Midwife" in Kirksville, Missouri. Her current practice location is
402 W Jefferson St, Kirksville, Missouri. You can reach out to her office (for appointments etc.) via phone at
(660) 665-3555.
Alisa Beth Fajkus is licensed to practice in Missouri (license number 2024026678) 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 1689355687.
Provider's Profile
| Full Name | Alisa Beth Fajkus |
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| Gender | Female |
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| Speciality | Advanced Practice Midwife |
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| Location | 402 W Jefferson St, Kirksville, Missouri |
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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: 1689355687
- Provider Enumeration Date: 07/31/2023
- Last Update Date: 11/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 2264979111
- Enrollment ID: I20240808004331
Medical Identifiers
Medical identifiers for Alisa Beth Fajkus such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689355687 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163WX0003X | Registered Nurse - Obstetric, Inpatient | 2013025730 (Missouri) | Secondary |
| 367A00000X | Advanced Practice Midwife | 2024026678 (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. Alisa Beth Fajkus allows following entities to bill medicare on her behalf.
| Entity Name | Northeast Missouri Health Council Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104829498
PECOS PAC ID: 1658280805
Enrollment ID: O20040112000061 |
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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. Alisa Beth Fajkus 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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Alisa Beth Fajkus, CNM
1416 Crown Dr,
Kirksville, MO 63501-2548
Ph: (660) 627-5757 | Alisa Beth Fajkus, CNM
402 W Jefferson St,
Kirksville, MO 63501-3407
Ph: (660) 665-3555 |
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