Haika Gloria Kisamo, in Marietta, GA - Medicare Nurse Practitioner

Haika Gloria Kisamo, is a medicare enrolled "Nurse Practitioner - Primary Care" in Marietta, Georgia. Her current practice location is 811 Kennesaw Ave Nw, Marietta, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 422-2451.

Haika Gloria Kisamo is licensed to practice in Georgia (license number RN270976) 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 1528741436.

Contact Information

	Haika Gloria Kisamo,
	811 Kennesaw Ave Nw, Marietta, GA 30060-1002
	(770) 422-2451
	Not Available

Map and Direction

Provider's Profile

Full Name	Haika Gloria Kisamo
Gender	Female
Speciality	Nurse Practitioner - Primary Care
Location	811 Kennesaw Ave Nw, Marietta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1528741436
Provider Enumeration Date: 08/08/2023
Last Update Date: 08/08/2023

Medicare PECOS Information:

PECOS PAC ID: 0143684688
Enrollment ID: I20230915002612

Medical Identifiers

Medical identifiers for Haika Gloria Kisamo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528741436	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	RN270976 (Georgia)	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. Haika Gloria Kisamo allows following entities to bill medicare on her behalf.

Entity Name	Hardy Renew Wellness,llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952914368 PECOS PAC ID: 2961812425 Enrollment ID: O20201112000534

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. Haika Gloria Kisamo 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
Haika Gloria Kisamo, 5323 Whitehaven Park Ln Se, Mableton, GA 30126-5957 Ph: (832) 818-0877	Haika Gloria Kisamo, 811 Kennesaw Ave Nw, Marietta, GA 30060-1002 Ph: (770) 422-2451

Reviews and Comments

Nurse Practitioner Nurses in Marietta, GA

Mrs. Jennifer Irene Sarno, ACNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 780 Canton Rd Ne, Suite 400, Marietta, GA 30060 Phone: 770-422-3602
Stacey Glass Malstrom, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 55 Whitcher St Ne Ste 350, Marietta, GA 30060 Phone: 770-424-6893
Tanisha Leonard, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 55 Whitcher St Ne Ste 350, Marietta, GA 30060 Phone: 770-424-6893 Fax: 770-528-9938
Julie J Baute, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 780 Canton Rd Ne Ste 205, Marietta, GA 30060 Phone: 678-224-6198
Dr. Ibisa Comfort Onyirimba, DNP, FNP-C, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2481 Hurt Rd Sw, Marietta, GA 30008 Phone: 404-934-2420
Mrs. Susan Wanjiku Kamau, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1579 Sage Ridge Dr, Marietta, GA 30064 Phone: 404-643-0444
Ms. Trina Renee Cain, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 811 Kennesaw Ave Nw, Marietta, GA 30060 Phone: 678-458-5311

Haika Gloria Kisamo, - Medicare Nurse Practitioner in Marietta, GA