Carolyn Jean Needham, FNP-C is a medicare enrolled "Nurse Practitioner" in Dundee, Michigan. Her current practice location is
1234 Plank Rd, Dundee, Michigan. You can reach out to her office (for appointments etc.) via phone at
(419) 344-9156.
Carolyn Jean Needham is licensed to practice in Michigan (license number 4704321112) 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 1124898291.
Provider's Profile
Full Name | Carolyn Jean Needham |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 1234 Plank Rd, Dundee, Michigan |
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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: 1124898291
- Provider Enumeration Date: 01/08/2024
- Last Update Date: 05/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 1052855566
- Enrollment ID: I20240625004226
Medical Identifiers
Medical identifiers for Carolyn Jean Needham such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124898291 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | 4704321112 (Michigan) | 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. Carolyn Jean Needham allows following entities to bill medicare on her behalf.
Entity Name | Promedica Northwest Ohio Cardiology Consultants Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1780820555 PECOS PAC ID: 4981752938 Enrollment ID: O20090504000036 |
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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. Carolyn Jean Needham 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 |
Carolyn Jean Needham, FNP-C 1234 Plank Rd, Dundee, MI 48131-9750 Ph: (419) 344-9156 | Carolyn Jean Needham, FNP-C 1234 Plank Rd, Dundee, MI 48131-9750 Ph: (419) 344-9156 |
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