Mrs Shyanne Marie Rosenbaum, FUNCTIONAL MEDICINE is a medicare enrolled "Nurse Practitioner" in Gallatin, Missouri. Her current practice location is
101 Industrial Pkwy, Gallatin, Missouri. You can reach out to her office (for appointments etc.) via phone at
(660) 663-2423.
Mrs Shyanne Marie Rosenbaum is licensed to practice in Missouri (license number 2021003417) 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 1669171799.
Provider's Profile
| Full Name | Mrs Shyanne Marie Rosenbaum |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 101 Industrial Pkwy, Gallatin, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1669171799
- Provider Enumeration Date: 02/27/2023
- Last Update Date: 07/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698133213
- Enrollment ID: I20230614000838
Medical Identifiers
Medical identifiers for Mrs Shyanne Marie Rosenbaum such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1669171799 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 2021003417 (Missouri) | 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 Shyanne Marie Rosenbaum allows following entities to bill medicare on her behalf.
| Entity Name | Cameron Regional Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811905375
PECOS PAC ID: 5092622001
Enrollment ID: O20040113000619 |
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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 Shyanne Marie Rosenbaum 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 |
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Mrs Shyanne Marie Rosenbaum, FUNCTIONAL MEDICINE
101 Industrial Pkwy,
Gallatin, MO 64640-7418
Ph: (660) 663-2423 | Mrs Shyanne Marie Rosenbaum, FUNCTIONAL MEDICINE
101 Industrial Pkwy,
Gallatin, MO 64640-7418
Ph: (660) 663-2423 |
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