Khudsiatu Tucker, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Bladensburg, Maryland. Her current practice location is
5632 Annapolis Rd Ste 11, Bladensburg, Maryland. You can reach out to her office (for appointments etc.) via phone at
(240) 486-7097.
Khudsiatu Tucker is licensed to practice in Maryland (license number R166523) 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 1831707488.
Provider's Profile
Full Name | Khudsiatu Tucker |
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Gender | Female |
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Speciality | Nurse Practitioner - Psychiatric/mental Health |
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Location | 5632 Annapolis Rd Ste 11, Bladensburg, Maryland |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1831707488
- Provider Enumeration Date: 07/20/2020
- Last Update Date: 05/14/2024
Medicare PECOS Information:
- PECOS PAC ID: 4587074455
- Enrollment ID: I20201104000589
Medical Identifiers
Medical identifiers for Khudsiatu Tucker such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1831707488 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | R166523 (Maryland) | Secondary |
363LF0000X | Nurse Practitioner - Family | 0024179570 (Virginia) | Secondary |
363LP0808X | Nurse Practitioner - Psychiatric/mental Health | R166523 (Maryland) | 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. Khudsiatu Tucker allows following entities to bill medicare on her behalf.
Entity Name | Minuteclinic Diagnostic Of Virginia Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1417076829 PECOS PAC ID: 6709960891 Enrollment ID: O20080228000067 |
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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. Khudsiatu Tucker 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 |
Khudsiatu Tucker, 5632 Annapolis Rd Ste 11, Bladensburg, MD 20710-2213 Ph: (240) 486-7097 | Khudsiatu Tucker, 5632 Annapolis Rd Ste 11, Bladensburg, MD 20710-2213 Ph: (240) 486-7097 |
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