Leslie Marie Wilson, PNP in Fort Worth, TX - Medicare Nurse Practitioner

Leslie Marie Wilson, PNP is a medicare enrolled "Nurse Practitioner - Pediatrics" in Fort Worth, Texas. Her current practice location is 8376 Mojave Trl, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 702-4881.

Leslie Marie Wilson is licensed to practice in Texas (license number 708360) 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 1255854121.

Contact Information

	Leslie Marie Wilson, PNP
	8376 Mojave Trl, Fort Worth, TX 76116-3638
	(817) 702-4881
	(817) 560-1940

Map and Direction

Provider's Profile

Full Name	Leslie Marie Wilson
Gender	Female
Speciality	Nurse Practitioner - Pediatrics
Location	8376 Mojave Trl, 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: 1255854121
Provider Enumeration Date: 07/21/2017
Last Update Date: 09/18/2018

Medicare PECOS Information:

PECOS PAC ID: 1355693219
Enrollment ID: I20181004001911

Medical Identifiers

Medical identifiers for Leslie Marie Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255854121	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0200X	Nurse Practitioner - Pediatrics	708360 (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. Leslie Marie Wilson allows following entities to bill medicare on her behalf.

Entity Name	Acclaim Physician Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780076562 PECOS PAC ID: 4587963582 Enrollment ID: O20160426000707

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. Leslie Marie Wilson 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
Leslie Marie Wilson, PNP Po Box 732973, Dallas, TX 75373-2973 Ph: (817) 702-8450	Leslie Marie Wilson, PNP 8376 Mojave Trl, Fort Worth, TX 76116-3638 Ph: (817) 702-4881

Reviews and Comments

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Leslie Marie Wilson, PNP - Medicare Nurse Practitioner in Fort Worth, TX