Koudedja Dembele, is a medicare enrolled "Clinical Nurse Specialist - Family Health" in New Rochelle, New York. Her current practice location is
16 Locust Ave Apt 1h, New Rochelle, New York. You can reach out to her office (for appointments etc.) via phone at
(914) 740-3792.
Koudedja Dembele is licensed to practice in New York (license number F338512-1) 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 1598290710.
Provider's Profile
| Full Name | Koudedja Dembele |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Family Health |
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| Location | 16 Locust Ave Apt 1h, New Rochelle, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1598290710
- Provider Enumeration Date: 04/25/2017
- Last Update Date: 04/25/2017
Medicare PECOS Information:
- PECOS PAC ID: 2567794191
- Enrollment ID: I20191030002912
Medical Identifiers
Medical identifiers for Koudedja Dembele such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1598290710 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SF0001X | Clinical Nurse Specialist - Family Health | F338512-1 (New York) | 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. Koudedja Dembele allows following entities to bill medicare on her behalf.
| Entity Name | Montefiore Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063525152
PECOS PAC ID: 3779496021
Enrollment ID: O20031113000235 |
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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. Koudedja Dembele 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 |
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Koudedja Dembele,
16 Locust Ave Apt 1h,
New Rochelle, NY 10801-7331
Ph: (914) 740-3792 | Koudedja Dembele,
16 Locust Ave Apt 1h,
New Rochelle, NY 10801-7331
Ph: (914) 740-3792 |
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