Mary Carol Kistner, CPNP in Fort Worth, TX - Medicare Nurse Practitioner

Mary Carol Kistner, CPNP is a medicare enrolled "Nurse Practitioner - Primary Care" in Fort Worth, Texas. Her current practice location is 1401 W Pulaski St, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (682) 885-8012.

Mary Carol Kistner is licensed to practice in Texas (license number AP117015) 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 1174787345.

Contact Information

	Mary Carol Kistner, CPNP
	1401 W Pulaski St, Fort Worth, TX 76104-2717
	(682) 885-8012
	(682) 885-8014

Map and Direction

Provider's Profile

Full Name	Mary Carol Kistner
Gender	Female
Speciality	Nurse Practitioner - Primary Care
Location	1401 W Pulaski St, 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: 1174787345
Provider Enumeration Date: 07/16/2008
Last Update Date: 07/03/2024

Medicare PECOS Information:

PECOS PAC ID: 8527106657
Enrollment ID: I20091111000178

Medical Identifiers

Medical identifiers for Mary Carol Kistner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174787345	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	505410 (Texas)	Secondary
363LP0200X	Nurse Practitioner - Pediatrics	AP117015 (Texas)	Secondary
363LP2300X	Nurse Practitioner - Primary Care	AP117015 (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. Mary Carol Kistner allows following entities to bill medicare on her behalf.

Entity Name	Cook Childrens Physician Network
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1750369203 PECOS PAC ID: 7719884584 Enrollment ID: O20040128000800

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. Mary Carol Kistner 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
Mary Carol Kistner, CPNP Po Box 99213, Fort Worth, TX 76199-0213 Ph: (682) 885-1860	Mary Carol Kistner, CPNP 1401 W Pulaski St, Fort Worth, TX 76104-2717 Ph: (682) 885-8012

Reviews and Comments

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Mary Carol Kistner, CPNP - Medicare Nurse Practitioner in Fort Worth, TX