Ibrahima T Diallo, APN in Bloomfield, NJ - Medicare Nurse Practitioner

Ibrahima T Diallo, APN is a medicare enrolled "Nurse Practitioner - Family" in Bloomfield, New Jersey. His current practice location is 135 Bloomfield Ave Ste F, Bloomfield, New Jersey. You can reach out to his office (for appointments etc.) via phone at (862) 213-0033.

Ibrahima T Diallo is licensed to practice in New Jersey (license number 26NJ01390500) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1639651714.

Contact Information

	Ibrahima T Diallo, APN
	135 Bloomfield Ave Ste F, Bloomfield, NJ 07003-5902
	(862) 213-0033
	Not Available

Map and Direction

Provider's Profile

Full Name	Ibrahima T Diallo
Gender	Male
Speciality	Nurse Practitioner - Family
Location	135 Bloomfield Ave Ste F, Bloomfield, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639651714
Provider Enumeration Date: 09/05/2018
Last Update Date: 08/14/2023

Medicare PECOS Information:

PECOS PAC ID: 4880057280
Enrollment ID: I20230901001151

Medical Identifiers

Medical identifiers for Ibrahima T Diallo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639651714	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WS0200X	Registered Nurse - School	727968-1 (New York)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
363LF0000X	Nurse Practitioner - Family	26NJ01390500 (New Jersey)	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. Ibrahima T Diallo allows following entities to bill medicare on his behalf.

Entity Name	Sm Medical Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1932562907 PECOS PAC ID: 6406145796 Enrollment ID: O20160510000034

Entity Name	Py Medical Services Of Nj Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942912381 PECOS PAC ID: 6901276922 Enrollment ID: O20230106002325

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. Ibrahima T Diallo 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
Ibrahima T Diallo, APN 25 Duncan Ave Apt 503, Jersey City, NJ 07304-4300 Ph: (201) 618-6623	Ibrahima T Diallo, APN 135 Bloomfield Ave Ste F, Bloomfield, NJ 07003-5902 Ph: (862) 213-0033

Reviews and Comments

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Ibrahima T Diallo, APN - Medicare Nurse Practitioner in Bloomfield, NJ