Belinda Fomba, in Fort Defiance, AZ - Medicare Nurse Practitioner

Belinda Fomba, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fort Defiance, Arizona. Her current practice location is Corner Of Route N12 And N7, Fort Defiance, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 729-8000.

Belinda Fomba is licensed to practice in Arizona (license number 219337) 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 1194434738.

Contact Information

	Belinda Fomba,
	Corner Of Route N12 And N7, Fort Defiance, AZ 86504-0649
	(928) 729-8000
	Not Available

Map and Direction

Provider's Profile

Full Name	Belinda Fomba
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	Corner Of Route N12 And N7, Fort Defiance, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1194434738
Provider Enumeration Date: 11/22/2022
Last Update Date: 05/04/2023

Medicare PECOS Information:

PECOS PAC ID: 2264898816
Enrollment ID: I20230524000491

Medical Identifiers

Medical identifiers for Belinda Fomba such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1194434738	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	219337 (Arizona)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	219337 (Arizona)	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. Belinda Fomba allows following entities to bill medicare on her behalf.

Entity Name	The Fort Defiance Indian Hospital Board, Incorporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477876639 PECOS PAC ID: 0941336697 Enrollment ID: O20100429001153

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. Belinda Fomba 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
Belinda Fomba, Po Box 649, Fort Defiance, AZ 86504-0649 Ph: () -	Belinda Fomba, Corner Of Route N12 And N7, Fort Defiance, AZ 86504-0649 Ph: (928) 729-8000

Reviews and Comments

Nurse Practitioner Nurses in Fort Defiance, AZ

Rosemary Josephine Bolza, CNM Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Intersection Of Highways 7 And 12, Fort Defiance, AZ 86504 Phone: 928-729-8775
Mrs. Patricia Nadurak, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Corner Of N12 And N8, Fort Defiance, AZ 86504 Phone: 928-729-8000
Jamie S Adams, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Corner Routes N7 & N12, Fort Defiance, AZ 86504 Phone: 928-729-8000
Kathryn Barron, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8821
June Ellen Rhoda, APRN-NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8000
Melonie I Blancaneaux, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Tseshootsooi Medical Center, Corner Of Route N12 And N7, Fort Defiance, AZ 86504 Phone: 928-729-8587
Ms. Jean Proper, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Corner Of Route N12 & N7, Fort Defiance, AZ 86504 Phone: 928-729-8000

Belinda Fomba, - Medicare Nurse Practitioner in Fort Defiance, AZ