Laksamana Perintis Nusantara, NP in Crowley, LA

Laksamana Perintis Nusantara, NP is a medicare enrolled "Nurse Practitioner - Family" in Crowley, Louisiana. His current practice location is 1307 Crowley Rayne Hwy Ste C, Crowley, Louisiana. You can reach out to his office (for appointments etc.) via phone at (337) 250-4710.

Laksamana Perintis Nusantara is licensed to practice in Florida (license number 11027192) 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 1205610607.

Contact Information

	Laksamana Perintis Nusantara, NP
	1307 Crowley Rayne Hwy Ste C, Crowley, LA 70526-8210
	(337) 250-4710
	Not Available

Map and Direction

Provider's Profile

Full Name	Laksamana Perintis Nusantara
Gender	Male
Speciality	Nurse Practitioner - Family
Location	1307 Crowley Rayne Hwy Ste C, Crowley, Louisiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205610607
Provider Enumeration Date: 08/24/2023
Last Update Date: 05/30/2024

Medicare PECOS Information:

PECOS PAC ID: 0244776912
Enrollment ID: I20240718002766

Medical Identifiers

Medical identifiers for Laksamana Perintis Nusantara such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205610607	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	11027192 (Florida)	Secondary

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. Laksamana Perintis Nusantara allows following entities to bill medicare on his behalf.

Entity Name	Pediatric Group Of Acadiana, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1265499628 PECOS PAC ID: 2466476023 Enrollment ID: O20060123000121

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. Laksamana Perintis Nusantara 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
Laksamana Perintis Nusantara, NP 1307 Crowley Rayne Hwy, Crowley, LA 70526-8210 Ph: (337) 250-4710	Laksamana Perintis Nusantara, NP 1307 Crowley Rayne Hwy Ste C, Crowley, LA 70526-8210 Ph: (337) 250-4710

Reviews and Comments

Nurse Practitioner Nurses in Crowley, LA

Lori Cox, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1325 Wright Ave Ste H, Crowley, LA 70526 Phone: 337-785-5440
April D Tolliver, APRN, MSN, PMHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 713 N Avenue L, Crowley, LA 70526 Phone: 225-336-7377
Heather Spallino Duplechain, MSN, APRN, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: Po Box 205, Crowley, LA 70527 Phone: 337-480-7792
Jonathan Hurts, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 526 Crowley Rayne Hwy, Crowley, LA 70526 Phone: 337-783-5519 Fax: 337-783-5521
Natasha Leblanc, FNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1455 Wright Ave Ste B, Crowley, LA 70526 Phone: 337-514-0900 Fax: 337-514-2006
Kate Louviere, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 713 N Avenue L, Crowley, LA 70526 Phone: 337-788-3330
Nickolas Matthews, APRN-CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1307 Crowley Rayne Hwy Ste B, Crowley, LA 70526 Phone: 337-783-6857 Fax: 337-783-6167

Laksamana Perintis Nusantara, NP - Medicare Nurse Practitioner in Crowley, LA