Mary Fuller-fougerousse, in Tucson, AZ - Medicare Nurse Practitioner

Mary Fuller-fougerousse, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Tucson, Arizona. Her current practice location is 502 W 29th St, Tucson, Arizona. You can reach out to her office (for appointments etc.) via phone at (520) 884-9920.

Mary Fuller-fougerousse is licensed to practice in Arizona (license number AP3545) 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 1336479906.

Contact Information

	Mary Fuller-fougerousse,
	502 W 29th St, Tucson, AZ 85713-3353
	(520) 884-9920
	Not Available

Map and Direction

Provider's Profile

Full Name	Mary Fuller-fougerousse
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	502 W 29th St, Tucson, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336479906
Provider Enumeration Date: 01/05/2010
Last Update Date: 02/22/2013

Medicare PECOS Information:

PECOS PAC ID: 9830232487
Enrollment ID: I20100204000088

Medical Identifiers

Medical identifiers for Mary Fuller-fougerousse such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336479906	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	AP3545 (Arizona)	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 Fuller-fougerousse allows following entities to bill medicare on her behalf.

Entity Name	La Frontera Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023119955 PECOS PAC ID: 0648171330 Enrollment ID: O20040115001022

Entity Name	Southeastern Arizona Behavioral Health Services, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760830137 PECOS PAC ID: 2860488368 Enrollment ID: O20040421000934

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 Fuller-fougerousse 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 Fuller-fougerousse, 502 W 29th St, Tucson, AZ 85713-3353 Ph: (520) 884-9920	Mary Fuller-fougerousse, 502 W 29th St, Tucson, AZ 85713-3353 Ph: (520) 884-9920

Reviews and Comments

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Mary Fuller-fougerousse, - Medicare Nurse Practitioner in Tucson, AZ