Ms Modupe D Mcintosh, CPNP in Clearwater, FL - Medicare Nurse Practitioner

Ms Modupe D Mcintosh, CPNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Clearwater, Florida. Her current practice location is 13577 Feather Sound Dr, Clearwater, Florida. You can reach out to her office (for appointments etc.) via phone at (904) 902-4408.

Ms Modupe D Mcintosh is licensed to practice in Florida (license number APRN11031023) 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 1174522916.

Contact Information

	Ms Modupe D Mcintosh, CPNP
	13577 Feather Sound Dr, Clearwater, FL 33762-2258
	(904) 902-4408
	(904) 420-4745

Map and Direction

Provider's Profile

Full Name	Ms Modupe D Mcintosh
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	13577 Feather Sound Dr, Clearwater, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174522916
Provider Enumeration Date: 07/14/2005
Last Update Date: 03/20/2024

Medicare PECOS Information:

PECOS PAC ID: 8921447947
Enrollment ID: I20240423002795

Medical Identifiers

Medical identifiers for Ms Modupe D Mcintosh such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174522916	NPI	-	NPPES
554500072A	Medicaid	GA
554500072D	Medicaid	GA
554500072E	Medicaid	GA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0200X	Nurse Practitioner - Pediatrics	RN092844 (Georgia)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	APRN11031023 (Florida)	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. Ms Modupe D Mcintosh allows following entities to bill medicare on her behalf.

Entity Name	Serenity Tms Centers, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1710492095 PECOS PAC ID: 0840550596 Enrollment ID: O20240321002859

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. Ms Modupe D Mcintosh 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
Ms Modupe D Mcintosh, CPNP 635 Beaver Ruin Rd Nw, Suite B, Lilburn, GA 30047-3474 Ph: (678) 807-2230	Ms Modupe D Mcintosh, CPNP 13577 Feather Sound Dr, Clearwater, FL 33762-2258 Ph: (904) 902-4408

Reviews and Comments

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Ms Modupe D Mcintosh, CPNP - Medicare Nurse Practitioner in Clearwater, FL