Kimberly Phillips Mizener, FNP in Fort Worth, TX

Kimberly Phillips Mizener, FNP is a medicare enrolled "Nurse Practitioner" in Fort Worth, Texas. Her current practice location is 1622 8th Ave Ste 110, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 920-0924.

Kimberly Phillips Mizener is licensed to practice in Texas (license number AP122836) 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 1174860597.

Contact Information

	Kimberly Phillips Mizener, FNP
	1622 8th Ave Ste 110, Fort Worth, TX 76104-4155
	(817) 920-0924
	(817) 921-3708

Map and Direction

Provider's Profile

Full Name	Kimberly Phillips Mizener
Gender	Female
Speciality	Nurse Practitioner
Location	1622 8th Ave Ste 110, Fort Worth, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174860597
Provider Enumeration Date: 01/04/2013
Last Update Date: 02/19/2015

Medicare PECOS Information:

PECOS PAC ID: 6800038811
Enrollment ID: I20130803000125

Medical Identifiers

Medical identifiers for Kimberly Phillips Mizener such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174860597	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	AP122836 (Texas)	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. Kimberly Phillips Mizener allows following entities to bill medicare on her behalf.

Entity Name	University Of Texas Southwestern Medical Center At Dallas
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1972579365 PECOS PAC ID: 0648188250 Enrollment ID: O20031106000792

Entity Name	Texas Health Care Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477628873 PECOS PAC ID: 7214840867 Enrollment ID: O20031110000388

Entity Name	Innovative Infusions Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1811299944 PECOS PAC ID: 6608054044 Enrollment ID: O20110707000108

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. Kimberly Phillips Mizener 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
Kimberly Phillips Mizener, FNP P.o. Box 961205, Fort Worth, TX 76161-1205 Ph: (817) 740-8400	Kimberly Phillips Mizener, FNP 1622 8th Ave Ste 110, Fort Worth, TX 76104-4155 Ph: (817) 920-0924

Reviews and Comments

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Kimberly Phillips Mizener, FNP - Medicare Nurse Practitioner in Fort Worth, TX