Leanna Marie Brooks Smith, CNP is a medicare enrolled "Nurse Practitioner - Family" in Ellsworth Air Force Base, South Dakota. Her current practice location is
2900 Doolittle Drive, Ellsworth Air Force Base, South Dakota. You can reach out to her office (for appointments etc.) via phone at
(605) 385-3111.
Leanna Marie Brooks Smith is licensed to practice in South Dakota (license number CP000344) 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 1407847726.
Provider's Profile
| Full Name | Leanna Marie Brooks Smith |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 2900 Doolittle Drive, Ellsworth Air Force Base, South Dakota |
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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: 1407847726
- Provider Enumeration Date: 11/04/2005
- Last Update Date: 05/03/2018
Medicare PECOS Information:
- PECOS PAC ID: 6204917917
- Enrollment ID: I20150209000244
Medical Identifiers
Medical identifiers for Leanna Marie Brooks Smith such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407847726 | NPI | - | NPPES |
| CP000344 | Other | SD | LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | CP000344 (South Dakota) | 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. Leanna Marie Brooks Smith allows following entities to bill medicare on her behalf.
| Entity Name | Bristol Bay Area Health Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235291246
PECOS PAC ID: 5890699920
Enrollment ID: O20031120000998 |
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| Entity Name | Pine Ridge Indian Health Service Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1497786412
PECOS PAC ID: 4688571326
Enrollment ID: O20031218000966 |
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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. Leanna Marie Brooks Smith 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 |
|---|
Leanna Marie Brooks Smith, CNP
2900 Doolittle Drive, Atten Medical Staff Services,
Ellsworth Air Force Base, SD 57706
Ph: (605) 385-3111 | Leanna Marie Brooks Smith, CNP
2900 Doolittle Drive,
Ellsworth Air Force Base, SD 57760
Ph: (605) 385-3111 |
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