Guadalupe Jisselle Rodriguez, FNP is a medicare enrolled "Nurse Practitioner - Family" in Maben, Mississippi. Her current practice location is
49 Turner St, Maben, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 263-5900.
Guadalupe Jisselle Rodriguez is licensed to practice in Mississippi (license number 904979) 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 1912659608.
Provider's Profile
| Full Name | Guadalupe Jisselle Rodriguez |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 49 Turner St, Maben, Mississippi |
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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: 1912659608
- Provider Enumeration Date: 01/24/2022
- Last Update Date: 05/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 4587050539
- Enrollment ID: I20220331001092
Medical Identifiers
Medical identifiers for Guadalupe Jisselle Rodriguez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1912659608 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 904979 (Mississippi) | 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. Guadalupe Jisselle Rodriguez allows following entities to bill medicare on her behalf.
| Entity Name | North Mississippi Medical Clinics Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053469486
PECOS PAC ID: 6103736665
Enrollment ID: O20040127000582 |
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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. Guadalupe Jisselle Rodriguez 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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Guadalupe Jisselle Rodriguez, FNP
Po Box 395,
Kosciusko, MS 39090-0395
Ph: () - | Guadalupe Jisselle Rodriguez, FNP
49 Turner St,
Maben, MS 39750-9157
Ph: (662) 263-5900 |
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