Mr Larry Lee Bousquet Ii, FNP in Fort Mohave, AZ

Mr Larry Lee Bousquet Ii, FNP is a medicare enrolled "Nurse Practitioner" in Fort Mohave, Arizona. His current practice location is 1611 E Joy Ln # 1, Fort Mohave, Arizona. You can reach out to his office (for appointments etc.) via phone at (928) 768-9496.

Mr Larry Lee Bousquet Ii is licensed to practice in Arizona (license number 283825) 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 1205544871.

Contact Information

	Mr Larry Lee Bousquet Ii, FNP
	1611 E Joy Ln # 1, Fort Mohave, AZ 86426-8807
	(928) 768-9496
	(928) 768-1943

Map and Direction

Provider's Profile

Full Name	Mr Larry Lee Bousquet Ii
Gender	Male
Speciality	Nurse Practitioner
Location	1611 E Joy Ln # 1, Fort Mohave, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1205544871
Provider Enumeration Date: 11/11/2022
Last Update Date: 11/11/2022

Medicare PECOS Information:

PECOS PAC ID: 6204206204
Enrollment ID: I20230109002573

Medical Identifiers

Medical identifiers for Mr Larry Lee Bousquet Ii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1205544871	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	283825 (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. Mr Larry Lee Bousquet Ii allows following entities to bill medicare on his behalf.

Entity Name	Mohave Family Healthcare
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043369168 PECOS PAC ID: 2860575941 Enrollment ID: O20080213000100

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. Mr Larry Lee Bousquet Ii 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
Mr Larry Lee Bousquet Ii, FNP 1611 E Joy Ln, Fort Mohave, AZ 86426-8807 Ph: (928) 768-9496	Mr Larry Lee Bousquet Ii, FNP 1611 E Joy Ln # 1, Fort Mohave, AZ 86426-8807 Ph: (928) 768-9496

Reviews and Comments

Nurse Practitioner Nurses in Fort Mohave, AZ

Mr. Ian Lloyd Ruiz Baccay, RN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5263 S Highway 95 , Fort Mohave, Az 86426, Fort Mohave, AZ 86426 Phone: 928-704-6400
Dilyara Cannon, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5653 S Highway 95, Ste A, Fort Mohave, AZ 86426 Phone: 928-768-2558 Fax: 928-768-2874
Kristen Peddycord, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5330 S Highway 95, Fort Mohave, AZ 86426 Phone: 928-788-2273
Deborah Ann Hughson, RNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5263 Hwy 95, Fort Mohave, AZ 86426 Phone: 928-704-6400 Fax: 928-768-1150
Theresa Marin, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1611 E Joy Ln, Fort Mohave, AZ 86426 Phone: 928-788-8000
Annie Marie Rodman, MSN/FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1510 E Wagon Wheel Ln, Suite 106, Fort Mohave, AZ 86426 Phone: 928-788-9378 Fax: 928-788-9381

Mr Larry Lee Bousquet Ii, FNP - Medicare Nurse Practitioner in Fort Mohave, AZ