Kimmie Phisaiwath, in Oklahoma City, OK - Medicare Nurse Practitioner

Kimmie Phisaiwath, is a medicare enrolled "Nurse Practitioner" in Oklahoma City, Oklahoma. Her current practice location is 9315 S Pennsylvania Ave Ste A, Oklahoma City, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (405) 691-9004.

Kimmie Phisaiwath is licensed to practice in Oklahoma (license number PENDING) 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 1639662216.

Contact Information

	Kimmie Phisaiwath,
	9315 S Pennsylvania Ave Ste A, Oklahoma City, OK 73159-6940
	(405) 691-9004
	(405) 691-9003

Map and Direction

Provider's Profile

Full Name	Kimmie Phisaiwath
Gender	Female
Speciality	Nurse Practitioner
Location	9315 S Pennsylvania Ave Ste A, Oklahoma City, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639662216
Provider Enumeration Date: 06/08/2018
Last Update Date: 06/12/2020

Medicare PECOS Information:

PECOS PAC ID: 3375894124
Enrollment ID: I20180918003751

Medical Identifiers

Medical identifiers for Kimmie Phisaiwath such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639662216	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	PENDING (Oklahoma)	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. Kimmie Phisaiwath allows following entities to bill medicare on her behalf.

Entity Name	David Quyen Le
Entity Type	Practitioner - Podiatry
Entity Identifiers	NPI Number: 1962566307 PECOS PAC ID: 3678553781 Enrollment ID: I20040727001391

Entity Name	Diabetic Foot And Wound Center Of Okfas
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780171009 PECOS PAC ID: 4981959509 Enrollment ID: O20180621001511

Entity Name	Enhanced Wound Care Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1306594148 PECOS PAC ID: 2769877000 Enrollment ID: O20220726000190

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. Kimmie Phisaiwath 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
Kimmie Phisaiwath, 9315 S Pennsylvania Avenue, Suite A, Oklahoma City, OK 73159 Ph: (405) 691-9004	Kimmie Phisaiwath, 9315 S Pennsylvania Ave Ste A, Oklahoma City, OK 73159-6940 Ph: (405) 691-9004

Reviews and Comments

Nurse Practitioner Nurses in Oklahoma City, OK

Ann R Benson, BSN, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1000 Ne 10th St, Oklahoma City, OK 73117 Phone: 405-271-4476 Fax: 405-271-9202
Mrs. Judy Kay Kellogg, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1025 Straka Ter, Oklahoma City, OK 73139 Phone: 405-632-6688 Fax: 405-604-0708
Mrs. Darbi Lynne Williams, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4050 W Memorial Rd, Oklahoma City, OK 73120 Phone: 405-608-3800 Fax: 405-608-3838
Tammy Ann Harrelson, APRN-CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 14000 N Portland Ave, Suite 201, Oklahoma City, OK 73134 Phone: 405-606-2727 Fax: 405-606-7040
Liji Seilas, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1901 Springlake Dr, Oklahoma City, OK 73111 Phone: 405-521-8486 Fax: 405-521-8496
Mrs. Rachel Leigh Cross, APRN, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1200 Childrens Ave, Suite 10000, Oklahoma City, OK 73104 Phone: 405-271-4412
Gretchen Fatherree, APRN, CNP-NNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1200 Everett Dr, Etnp 7504, Oklahoma City, OK 73104 Phone: 405-271-5215

Kimmie Phisaiwath, - Medicare Nurse Practitioner in Oklahoma City, OK