Mr Jack Facundus, ARNP in Longwood, FL - Medicare Nurse Practitioner

Mr Jack Facundus, ARNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Longwood, Florida. His current practice location is 651 W Warren Ave Ste 100, Longwood, Florida. You can reach out to his office (for appointments etc.) via phone at (321) 999-9617.

Mr Jack Facundus is licensed to practice in Florida (license number APRN2824142) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1376092809.

Contact Information

	Mr Jack Facundus, ARNP
	651 W Warren Ave Ste 100, Longwood, FL 32750-4036
	(321) 999-9617
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jack Facundus
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	651 W Warren Ave Ste 100, Longwood, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376092809
Provider Enumeration Date: 09/26/2016
Last Update Date: 06/14/2024

Medicare PECOS Information:

PECOS PAC ID: 5294102703
Enrollment ID: I20230515001497

Medical Identifiers

Medical identifiers for Mr Jack Facundus such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376092809	NPI	-	NPPES
F0416038	Other	FL	AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION PROGRAM
ARNP2824142	Other	FL	STATE OF FLORIDA ARNP LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	ARNP2824142 (Florida)	Secondary
363LF0000X	Nurse Practitioner - Family	090740-23 (New Hampshire)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	APRN2824142 (Florida)	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. Mr Jack Facundus allows following entities to bill medicare on his behalf.

Entity Name	Dartmouth-hitchcock Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1548210198 PECOS PAC ID: 4183537509 Enrollment ID: O20040809000442

Entity Name	Cheshire Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093803397 PECOS PAC ID: 1456260165 Enrollment ID: O20070913000090

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. Mr Jack Facundus 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
Mr Jack Facundus, ARNP 5151 Adanson St, Orlando, FL 32804-1317 Ph: (407) 875-3700	Mr Jack Facundus, ARNP 651 W Warren Ave Ste 100, Longwood, FL 32750-4036 Ph: (321) 999-9617

Reviews and Comments

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Mr Jack Facundus, ARNP - Medicare Nurse Practitioner in Longwood, FL