Mr Mike Maurice Supplice, ARNP is a medicare enrolled "Anesthesiology - Critical Care Medicine" in Tallahassee, Florida. His current practice location is
2009 Miccosukee Rd, Tallahassee, Florida. You can reach out to his office (for appointments etc.) via phone at
(850) 942-2299.
Mr Mike Maurice Supplice is licensed to practice in Georgia (license number RN210166) 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 1689000101.
Provider's Profile
Full Name | Mr Mike Maurice Supplice |
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Gender | Male |
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Speciality | Anesthesiology - Critical Care Medicine |
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Location | 2009 Miccosukee Rd, Tallahassee, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1689000101
- Provider Enumeration Date: 09/16/2013
- Last Update Date: 11/10/2022
Medicare PECOS Information:
- PECOS PAC ID: 9830493949
- Enrollment ID: I20160210002299
Medical Identifiers
Medical identifiers for Mr Mike Maurice Supplice such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1689000101 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363L00000X | Nurse Practitioner | ARNP9290091 (Florida) | Secondary |
207LC0200X | Anesthesiology - Critical Care Medicine | RN210166 (Georgia) | 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 Mike Maurice Supplice allows following entities to bill medicare on his behalf.
Entity Name | Paragon Emergency Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1912101650 PECOS PAC ID: 8628153087 Enrollment ID: O20080310000143 |
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Entity Name | Deerfield Beach Physician Services, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366100364 PECOS PAC ID: 3274928270 Enrollment ID: O20220520002459 |
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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 Mike Maurice Supplice 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 Mike Maurice Supplice, ARNP 2009 Miccosukee Rd, Tallahassee, FL 32308-5359 Ph: (850) 942-2299 | Mr Mike Maurice Supplice, ARNP 2009 Miccosukee Rd, Tallahassee, FL 32308-5359 Ph: (850) 942-2299 |
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