Martha Maxine Puckett, FNP in De Kalb, MS - Medicare Nurse Practitioner

Martha Maxine Puckett, FNP is a medicare enrolled "Nurse Practitioner - Family" in De Kalb, Mississippi. Her current practice location is 14365 Highway 16 W, De Kalb, Mississippi. You can reach out to her office (for appointments etc.) via phone at (601) 743-4626.

Martha Maxine Puckett is licensed to practice in Mississippi (license number R518425) 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 1104808732.

Contact Information

	Martha Maxine Puckett, FNP
	14365 Highway 16 W, De Kalb, MS 39328-7974
	(601) 743-4626
	(601) 743-2133

Map and Direction

Provider's Profile

Full Name	Martha Maxine Puckett
Gender	Female
Speciality	Nurse Practitioner - Family
Location	14365 Highway 16 W, De Kalb, Mississippi
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104808732
Provider Enumeration Date: 11/18/2005
Last Update Date: 10/13/2024

Medicare PECOS Information:

PECOS PAC ID: 7113182114
Enrollment ID: I20120625000555

Medical Identifiers

Medical identifiers for Martha Maxine Puckett such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104808732	NPI	-	NPPES
00111106	Medicaid	MS
891001100	Medicaid	AL
731-02812	Other		BLUE CROSS OF AL
970006574	Other		RAILROAD MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	R518425 (Mississippi)	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. Martha Maxine Puckett allows following entities to bill medicare on her behalf.

Entity Name	Rush Medical Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588625594 PECOS PAC ID: 2567368541 Enrollment ID: O20031210000541

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. Martha Maxine Puckett 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
Martha Maxine Puckett, FNP 1314 19th Ave, Meridian, MS 39301-4116 Ph: (601) 703-4282	Martha Maxine Puckett, FNP 14365 Highway 16 W, De Kalb, MS 39328-7974 Ph: (601) 743-4626

Reviews and Comments

Nurse Practitioner Nurses in De Kalb, MS

Latorya Barron, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 201 Birch St, De Kalb, MS 39328 Phone: 601-743-2642
Mrs. Sammy Elizabeth Kratzer, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 14365 Highway 16 W, De Kalb, MS 39328 Phone: 769-486-1000
Hannah Gray, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 201 Birch St, De Kalb, MS 39328 Phone: 601-743-2643 Fax: 601-553-8175

Martha Maxine Puckett, FNP - Medicare Nurse Practitioner in De Kalb, MS