Destiny Ibrom, FNP - Medicare Nurse Practitioner in Port Lavaca, TX

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Destiny Ibrom, FNP is a medicare enrolled "Nurse Practitioner - Family" in Port Lavaca, Texas. Her current practice location is 1200 N Virginia St, Port Lavaca, Texas. You can reach out to her office (for appointments etc.) via phone at (361) 552-6721.

Destiny Ibrom is licensed to practice in Texas (license number AP136422) 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 1487153573.

Contact Information

Destiny Ibrom, FNP
1200 N Virginia St,
Port Lavaca, TX 77979-2507
(361) 552-6721
Not Available

Map and Direction




Provider's Profile

Full NameDestiny Ibrom
GenderFemale
SpecialityNurse Practitioner - Family
Location1200 N Virginia St, Port Lavaca, Texas
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1487153573
  • Provider Enumeration Date: 02/05/2018
  • Last Update Date: 11/01/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 5395009534
  • Enrollment ID: I20180516000040

Medical Identifiers

Medical identifiers for Destiny Ibrom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1487153573NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family AP136422 (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. Destiny Ibrom allows following entities to bill medicare on her behalf.
Entity NameRegional Employee Assistance Program Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649232984
PECOS PAC ID: 1557260064
Enrollment ID: O20040612000731
Entity NamePort Lavaca Clinic Associates Pa
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1144262957
PECOS PAC ID: 3971565193
Enrollment ID: O20041101000085

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. Destiny Ibrom 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 AddressPractice Location Address
Destiny Ibrom, FNP
1200 N Virginia St,
Port Lavaca, TX 77979-2507

Ph: () -		Destiny Ibrom, FNP
1200 N Virginia St,
Port Lavaca, TX 77979-2507

Ph: (361) 552-6721

Reviews and Comments


Nurse Practitioner Nurses in Port Lavaca, TX

Michael Leon Gaines, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 815 N Virginia St Fl 2, Port Lavaca, TX 77979
Phone: 361-552-0379    Fax: 361-500-6904
Mrs. Tasha Norman, MSN, APRN, FNP-C
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 1016 N Virginia St, Port Lavaca, TX 77979
Phone: 361-552-0325    Fax: 361-500-6904
Mr. Gregorio Jose Robles Fernandez,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 225 N Virginia St, Port Lavaca, TX 77979
Phone: 832-691-4694    
Courtne Thurlkill, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1016 N Virginia St, Port Lavaca, TX 77979
Phone: 361-552-0325    Fax: 361-500-6904
Kristi Boyd, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 815 N Virginia St, Port Lavaca, TX 77979
Phone: 361-552-6713    
Mrs. Shanmei Lin Martinez, FNP-C
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 1016 N Virginia St, Port Lavaca, TX 77979
Phone: 361-552-0325    
Mrs. Nichole Lynn Bruno, CPNP
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 1300 N. Virginia Street, Port Lavaca, TX 77979
Phone: 361-553-6844    Fax: 361-553-7314

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.