Mary Koenen, FNP in Grand Rapids, MI - Medicare Nurse Practitioner

Mary Koenen, FNP is a medicare enrolled "Nurse Practitioner - Family" in Grand Rapids, Michigan. Her current practice location is 72 Sheldon Blvd Se, Grand Rapids, Michigan. You can reach out to her office (for appointments etc.) via phone at (616) 988-8774.

Mary Koenen is licensed to practice in Michigan (license number MK4704154566) 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 1184777682.

Contact Information

	Mary Koenen, FNP
	72 Sheldon Blvd Se, Grand Rapids, MI 49503-4234
	(616) 988-8774
	(616) 988-8775

Map and Direction

Provider's Profile

Full Name	Mary Koenen
Gender	Female
Speciality	Nurse Practitioner - Family
Location	72 Sheldon Blvd Se, Grand Rapids, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184777682
Provider Enumeration Date: 01/19/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 1759561665
Enrollment ID: I20110210000133

Medical Identifiers

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

Identifier	Type	State	Issuer
1184777682	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	MK4704154566 (Michigan)	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 Koenen allows following entities to bill medicare on her behalf.

Entity Name	Baxter Community Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1164625109 PECOS PAC ID: 6204825524 Enrollment ID: O20040511000585

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 Koenen 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 Koenen, FNP 72 Sheldon Blvd Se, Grand Rapids, MI 49503-4234 Ph: (616) 988-8774	Mary Koenen, FNP 72 Sheldon Blvd Se, Grand Rapids, MI 49503-4234 Ph: (616) 988-8774

Reviews and Comments

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Mary Koenen, FNP - Medicare Nurse Practitioner in Grand Rapids, MI