Ivy Tidwell Prothro, FNP-BC in Bethesda, MD - Medicare Nurse Practitioner

Ivy Tidwell Prothro, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" in Bethesda, Maryland. She went to Duke University School Of Medicine and graduated in 2019 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Kelly Goodman, Np And Associates Pc and her current practice location is 4701 Sangamore Rd Ste S207, Bethesda, Maryland. You can reach out to her office (for appointments etc.) via phone at (202) 684-7176.

Ivy Tidwell Prothro is licensed to practice in Maryland (license number R241507) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1811529381.

Contact Information

	Ivy Tidwell Prothro, FNP-BC
	4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529
	(202) 684-7176
	Not Available

Map and Direction

Provider's Profile

Full Name	Ivy Tidwell Prothro
Gender	Female
Speciality	Nurse Practitioner
Experience	5 Years
Location	4701 Sangamore Rd Ste S207, Bethesda, Maryland
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Ivy Tidwell Prothro attended and graduated from Duke University School Of Medicine in 2019

NPI Data:

NPI Number: 1811529381
Provider Enumeration Date: 02/12/2020
Last Update Date: 02/12/2020

Medicare PECOS Information:

PECOS PAC ID: 0941612543
Enrollment ID: I20201223000275

Medical Identifiers

Medical identifiers for Ivy Tidwell Prothro such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1811529381	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R241507 (Maryland)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Kelly Goodman, Np And Associates Pc	0042344988	4

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. Ivy Tidwell Prothro allows following entities to bill medicare on her behalf.

Entity Name	Kelly Goodman, Np & Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1740503689 PECOS PAC ID: 0042344988 Enrollment ID: O20100814000141

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. Ivy Tidwell Prothro 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
Ivy Tidwell Prothro, FNP-BC 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 Ph: (202) 684-7167	Ivy Tidwell Prothro, FNP-BC 4701 Sangamore Rd Ste S207, Bethesda, MD 20816-2529 Ph: (202) 684-7176

Reviews and Comments

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Ivy Tidwell Prothro, FNP-BC - Medicare Nurse Practitioner in Bethesda, MD