Oluwayemisi O Agboola, FNP in Fort Worth, TX - Medicare Nurse Practitioner

Oluwayemisi O Agboola, FNP is a medicare enrolled "Nurse Practitioner - Family" in Fort Worth, Texas. Her current practice location is 855 Montgomery St, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 702-6100.

Oluwayemisi O Agboola is licensed to practice in Texas (license number 798878) 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 1114210648.

Contact Information

	Oluwayemisi O Agboola, FNP
	855 Montgomery St, Fort Worth, TX 76107-2553
	(817) 702-6100
	Not Available

Map and Direction

Provider's Profile

Full Name	Oluwayemisi O Agboola
Gender	Female
Speciality	Nurse Practitioner - Family
Location	855 Montgomery St, Fort Worth, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114210648
Provider Enumeration Date: 05/17/2011
Last Update Date: 10/16/2014

Medicare PECOS Information:

PECOS PAC ID: 2365602224
Enrollment ID: I20120329000866

Medical Identifiers

Medical identifiers for Oluwayemisi O Agboola such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114210648	NPI	-	NPPES
295160004	Medicaid	TX
8562NK	Other	TX	BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	SP010939 (Pennsylvania)	Secondary
363LF0000X	Nurse Practitioner - Family	798878 (Texas)	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. Oluwayemisi O Agboola allows following entities to bill medicare on her behalf.

Entity Name	Integrative Emergency Services Physician Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285922542 PECOS PAC ID: 0749447936 Enrollment ID: O20120130000932

Entity Name	Mydas Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1508296583 PECOS PAC ID: 6406083617 Enrollment ID: O20131214000233

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. Oluwayemisi O Agboola 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
Oluwayemisi O Agboola, FNP Po Box 99335, Fort Worth, TX 76199-0335 Ph: () -	Oluwayemisi O Agboola, FNP 855 Montgomery St, Fort Worth, TX 76107-2553 Ph: (817) 702-6100

Reviews and Comments

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Oluwayemisi O Agboola, FNP - Medicare Nurse Practitioner in Fort Worth, TX