Latasha Crockett, in Fort Worth, TX - Medicare Nurse Practitioner

Latasha Crockett, is a medicare enrolled "Nurse Practitioner - Acute Care" in Fort Worth, Texas. Her current practice location is 6000 Western Pl Ste 900, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 740-8400.

Latasha Crockett is licensed to practice in Texas (license number 1091068) 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 1417661588.

Contact Information

	Latasha Crockett,
	6000 Western Pl Ste 900, Fort Worth, TX 76107-4691
	(817) 740-8400
	Not Available

Map and Direction

Provider's Profile

Full Name	Latasha Crockett
Gender	Female
Speciality	Nurse Practitioner - Acute Care
Location	6000 Western Pl Ste 900, 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: 1417661588
Provider Enumeration Date: 01/12/2023
Last Update Date: 04/23/2024

Medicare PECOS Information:

PECOS PAC ID: 0446623417
Enrollment ID: I20230223000070

Medical Identifiers

Medical identifiers for Latasha Crockett such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417661588	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	1091068 (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. Latasha Crockett allows following entities to bill medicare on her behalf.

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	Attigo Infusion Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1891339644 PECOS PAC ID: 5597190645 Enrollment ID: O20200117000376

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. Latasha Crockett 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
Latasha Crockett, 5020 Chisholm View Dr, Fort Worth, TX 76123-1575 Ph: (254) 413-3157	Latasha Crockett, 6000 Western Pl Ste 900, Fort Worth, TX 76107-4691 Ph: (817) 740-8400

Reviews and Comments

Nurse Practitioner Nurses in Fort Worth, TX

Mrs. Amy Michelle Medalie, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4405 River Oaks Blvd, Fort Worth, TX 76114 Phone: 817-624-1770 Fax: 817-625-1287
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Kristi E Tucker, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 801 7th Ave, Fort Worth, TX 76104 Phone: 682-885-1475 Fax: 682-885-7520
Lacy Pitchford, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1263 W Rosedale St Ste 200, Fort Worth, TX 76104 Phone: 817-336-4896 Fax: 817-332-2805
Mary Agnes Johnson, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1400 8th Ave, Fort Worth, TX 76104 Phone: 817-922-7070
Susan Akberzie, CPNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1401 W Pulaski St, Fort Worth, TX 76104 Phone: 682-885-8012 Fax: 682-885-8014

Latasha Crockett, - Medicare Nurse Practitioner in Fort Worth, TX