Dr John S Inthavongsa, DNP RN AGACNP-BC in Detroit, MI

Dr John S Inthavongsa, DNP RN AGACNP-BC is a medicare enrolled "Nurse Practitioner - Acute Care" in Detroit, Michigan. He went to University Of Michigan Medical School and graduated in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Methodist Associates In Healthcare, Inc and his current practice location is 4201 Saint Antoine St, Detroit, Michigan. You can reach out to his office (for appointments etc.) via phone at (313) 745-3000.

Dr John S Inthavongsa is licensed to practice in Michigan (license number 4704309696) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1588220222.

Contact Information

	Dr John S Inthavongsa, DNP RN AGACNP-BC
	4201 Saint Antoine St, Detroit, MI 48201-2153
	(313) 745-3000
	(313) 745-4707

Map and Direction

Provider's Profile

Full Name	Dr John S Inthavongsa
Gender	Male
Speciality	Nurse Practitioner
Experience	5 Years
Location	4201 Saint Antoine St, Detroit, Michigan
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr John S Inthavongsa attended and graduated from University Of Michigan Medical School in 2019

NPI Data:

NPI Number: 1588220222
Provider Enumeration Date: 05/17/2019
Last Update Date: 06/04/2021

Medicare PECOS Information:

PECOS PAC ID: 9133451008
Enrollment ID: I20230110001712

Medical Identifiers

Medical identifiers for Dr John S Inthavongsa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588220222	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	4704309696 (Michigan)	Secondary
363LA2100X	Nurse Practitioner - Acute Care	4704309696 (Michigan)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Methodist Associates In Healthcare, Inc	6406755651	290

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. Dr John S Inthavongsa allows following entities to bill medicare on his behalf.

Entity Name	Methodist Associates In Healthcare, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1053355131 PECOS PAC ID: 6406755651 Enrollment ID: O20040402000835

Entity Name	University Of Penn-medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235527342 PECOS PAC ID: 6204730955 Enrollment ID: O20141111000091

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. Dr John S Inthavongsa 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
Dr John S Inthavongsa, DNP RN AGACNP-BC 454 W Alexandrine St Apt 18, Detroit, MI 48201-1787 Ph: (347) 963-1896	Dr John S Inthavongsa, DNP RN AGACNP-BC 4201 Saint Antoine St, Detroit, MI 48201-2153 Ph: (313) 745-3000

Reviews and Comments

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Dr John S Inthavongsa, DNP RN AGACNP-BC - Medicare Nurse Practitioner in Detroit, MI