Mrs Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C in Grand Rapids, MI

Mrs Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C is a medicare enrolled "Nurse Practitioner - Family" in Grand Rapids, Michigan. Her current practice location is 1752 Southampton Dr Se, Grand Rapids, Michigan. You can reach out to her office (for appointments etc.) via phone at (616) 889-3665.

Mrs Siddeequa Moneek Bradshaw is licensed to practice in Michigan (license number 4704251077) 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 1124624465.

Contact Information

	Mrs Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C
	1752 Southampton Dr Se, Grand Rapids, MI 49508-2647
	(616) 889-3665
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Siddeequa Moneek Bradshaw
Gender	Female
Speciality	Nurse Practitioner - Family
Location	1752 Southampton Dr Se, Grand Rapids, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1124624465
Provider Enumeration Date: 12/10/2020
Last Update Date: 12/10/2020

Medicare PECOS Information:

PECOS PAC ID: 8426431362
Enrollment ID: I20220810002048

Medical Identifiers

Medical identifiers for Mrs Siddeequa Moneek Bradshaw such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124624465	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	4704251077 (Michigan)	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 Siddeequa Moneek Bradshaw allows following entities to bill medicare on her behalf.

Entity Name	Avanti Wound Physicians Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801398789 PECOS PAC ID: 7810251782 Enrollment ID: O20180430001756

Entity Name	Curana Health Of Michigan Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1659921278 PECOS PAC ID: 9638502917 Enrollment ID: O20200826001179

Entity Name	Applebaum Physiatry Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1700598059 PECOS PAC ID: 8729453436 Enrollment ID: O20230413000778

Entity Name	Ch Mssp Services Mi Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609569169 PECOS PAC ID: 2961862800 Enrollment ID: O20230724002653

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 Siddeequa Moneek Bradshaw 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 Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C Po Box 1268, Grand Rapids, MI 49501-1268 Ph: (616) 889-3665	Mrs Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C 1752 Southampton Dr Se, Grand Rapids, MI 49508-2647 Ph: (616) 889-3665

Reviews and Comments

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Mary Barr, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4100 Lake Dr Se Ste 200, Grand Rapids, MI 49546 Phone: 616-391-3759

Mrs Siddeequa Moneek Bradshaw, MSN, APRN, FNP-C - Medicare Nurse Practitioner in Grand Rapids, MI