Mrs Fawn Shelley Mumbulo, FNP-C in Sherburne, NY

Mrs Fawn Shelley Mumbulo, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Sherburne, New York. Her current practice location is 20 Chapel St, Sherburne, New York. You can reach out to her office (for appointments etc.) via phone at (607) 674-2445.

Mrs Fawn Shelley Mumbulo is licensed to practice in New York (license number F338835-1) 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 1720493984.

Contact Information

	Mrs Fawn Shelley Mumbulo, FNP-C
	20 Chapel St, Sherburne, NY 13460-9753
	(607) 674-2445
	(607) 674-4338

Map and Direction

Provider's Profile

Full Name	Mrs Fawn Shelley Mumbulo
Gender	Female
Speciality	Nurse Practitioner - Family
Location	20 Chapel St, Sherburne, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720493984
Provider Enumeration Date: 06/26/2014
Last Update Date: 06/27/2014

Medicare PECOS Information:

PECOS PAC ID: 0244459931
Enrollment ID: I20140911000184

Medical Identifiers

Medical identifiers for Mrs Fawn Shelley Mumbulo such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720493984	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	F338835-1 (New York)	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. Mrs Fawn Shelley Mumbulo allows following entities to bill medicare on her behalf.

Entity Name	Chenango Memorial Hospital Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770593956 PECOS PAC ID: 7517853633 Enrollment ID: O20040225000911

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. Mrs Fawn Shelley Mumbulo 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
Mrs Fawn Shelley Mumbulo, FNP-C Po Box 725, Cooperstown, NY 13326-0725 Ph: (607) 674-2445	Mrs Fawn Shelley Mumbulo, FNP-C 20 Chapel St, Sherburne, NY 13460-9753 Ph: (607) 674-2445

Reviews and Comments

Nurse Practitioner Nurses in Sherburne, NY

Gabrielle Theresa O'reilly, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13 School St, Sherburne, NY 13460 Phone: 607-674-8416 Fax: 607-547-8415
Martha Lynn Smith, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20 Chapel St, Sherburne, NY 13460 Phone: 607-674-2445 Fax: 607-674-4338
Mr. Ryan R Gayfield, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20 Chapel Street, Sherburne, NY 13460 Phone: 607-674-2445
Casey Laura Coon, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13 School St, Sherburne, NY 13460 Phone: 607-674-8416
Alexandra Grace Durantini, AGPCNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 20 Chapel St, Sherburne, NY 13460 Phone: 607-674-2445 Fax: 607-674-4338

Mrs Fawn Shelley Mumbulo, FNP-C - Medicare Nurse Practitioner in Sherburne, NY