Mrs Mary Illig Minielly, APRN in Oklahoma City, OK

Mrs Mary Illig Minielly, APRN is a medicare enrolled "Nurse Practitioner" in Oklahoma City, Oklahoma. Her current practice location is 8100 S. Walker Avenue, Building A, Oklahoma City, Oklahoma. You can reach out to her office (for appointments etc.) via phone at (405) 632-4468.

Mrs Mary Illig Minielly is licensed to practice in Oklahoma (license number R0059137) 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 1417086380.

Contact Information

	Mrs Mary Illig Minielly, APRN
	8100 S. Walker Avenue, Building A, Oklahoma City, OK 73139-9404
	(405) 632-4468
	(405) 631-4964

Map and Direction

Provider's Profile

Full Name	Mrs Mary Illig Minielly
Gender	Female
Speciality	Nurse Practitioner
Location	8100 S. Walker Avenue, Oklahoma City, Oklahoma
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1417086380
Provider Enumeration Date: 03/05/2007
Last Update Date: 03/07/2023

Medicare PECOS Information:

PECOS PAC ID: 5890852586
Enrollment ID: I20090325000101

Medical Identifiers

Medical identifiers for Mrs Mary Illig Minielly such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1417086380	NPI	-	NPPES
100130740A	Other	OK	OHCA
28812	Other	OK	ONBDD
100130740A	Other	OK	SOONERCARE
12317438	Other	OK	CAQH
1417086380	Other	OK	NPI
59137	Other	OK	LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	R0059137 (Oklahoma)	Primary
363LA2100X	Nurse Practitioner - Acute Care	R0059137 (Oklahoma)	Secondary

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 Mary Illig Minielly allows following entities to bill medicare on her behalf.

Entity Name	Warren Clinic Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1174582282 PECOS PAC ID: 8820900293 Enrollment ID: O20031104000252

Entity Name	Emergency Medicine Physicians Of Tulsa County Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003098773 PECOS PAC ID: 8628140225 Enrollment ID: O20080626000116

Entity Name	Usacs Observation Medicine Services Of Oklahoma, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326739111 PECOS PAC ID: 9931562956 Enrollment ID: O20230823004181

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 Mary Illig Minielly 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 Mary Illig Minielly, APRN 8100 S. Walker Avenue, Building A, Oklahoma City, OK 73139-9404 Ph: (405) 632-4468	Mrs Mary Illig Minielly, APRN 8100 S. Walker Avenue, Building A, Oklahoma City, OK 73139-9404 Ph: (405) 632-4468

Reviews and Comments

Nurse Practitioner Nurses in Oklahoma City, OK

Ann R Benson, BSN, ARNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1000 Ne 10th St, Oklahoma City, OK 73117 Phone: 405-271-4476 Fax: 405-271-9202
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Liji Seilas, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1901 Springlake Dr, Oklahoma City, OK 73111 Phone: 405-521-8486 Fax: 405-521-8496
Mrs. Rachel Leigh Cross, APRN, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1200 Childrens Ave, Suite 10000, Oklahoma City, OK 73104 Phone: 405-271-4412
Gretchen Fatherree, APRN, CNP-NNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1200 Everett Dr, Etnp 7504, Oklahoma City, OK 73104 Phone: 405-271-5215

Mrs Mary Illig Minielly, APRN - Medicare Nurse Practitioner in Oklahoma City, OK