Theresa D Fontaine, NP is a medicare enrolled "Nurse Practitioner" in Ozark, Arkansas. She graduated from nursing school in 2017 and has 7 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mercy Clinic Fort Smith Communities and her current practice location is
201 S 7th St, Ozark, Arkansas. You can reach out to her office (for appointments etc.) via phone at
(479) 667-1590.
Theresa D Fontaine is licensed to practice in Arkansas (license number A005460) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1639687437.
Provider's Profile
| Full Name | Theresa D Fontaine |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 7 Years |
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| Location | 201 S 7th St, Ozark, Arkansas |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Theresa D Fontaine graduated from nursing school in 2017
NPI Data:
- NPI Number: 1639687437
- Provider Enumeration Date: 01/15/2018
- Last Update Date: 01/15/2018
Medicare PECOS Information:
- PECOS PAC ID: 2264792522
- Enrollment ID: I20180205002455
Medical Identifiers
Medical identifiers for Theresa D Fontaine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1639687437 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | A005460 (Arkansas) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mercy Clinic Fort Smith Communities | 3870668510 | 283 |
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. Theresa D Fontaine allows following entities to bill medicare on her behalf.
| Entity Name | Mercy Clinic Fort Smith Communities |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1902073620
PECOS PAC ID: 3870668510
Enrollment ID: O20080814000789 |
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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. Theresa D Fontaine 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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Theresa D Fontaine, NP
2901 S 74th St,
Fort Smith, AR 72903-5156
Ph: (314) 364-7595 | Theresa D Fontaine, NP
201 S 7th St,
Ozark, AR 72949-3131
Ph: (479) 667-1590 |
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