Etinosa Obadagbonyi, in Fort Moore, GA - Medicare Occupational Therapist Provider

Etinosa Obadagbonyi, is a medicare enrolled "Occupational Therapist" provider in Fort Moore, Georgia. His current practice location is 6600 Van Aalst Blvd, Fort Moore, Georgia. You can reach out to his office (for appointments etc.) via phone at (832) 264-1759.

Etinosa Obadagbonyi is licensed to practice in Texas (license number 120260) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1699373092.

Contact Information

	Etinosa Obadagbonyi,
	6600 Van Aalst Blvd, Fort Moore, GA 31905-2102
	(832) 264-1759
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Etinosa Obadagbonyi
Gender	Male
Speciality	Occupational Therapist
Location	6600 Van Aalst Blvd, Fort Moore, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1699373092
Provider Enumeration Date: 10/16/2020
Last Update Date: 11/26/2023

Medicare PECOS Information:

PECOS PAC ID: 7911317912
Enrollment ID: I20201103000859

Medical Identifiers

Medical identifiers for Etinosa Obadagbonyi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1699373092	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225X00000X	Occupational Therapist	120260 (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. Etinosa Obadagbonyi allows following entities to bill medicare on his behalf.

Provider Name	Lymphedema Therapy Specialists Inc.
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1578104352 PECOS PAC ID: 4183956451 Enrollment ID: O20191106001489

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. Etinosa Obadagbonyi 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
Etinosa Obadagbonyi, 6600 Van Aalst Blvd, Fort Moore, GA 31905-2102 Ph: (832) 264-1759	Etinosa Obadagbonyi, 6600 Van Aalst Blvd, Fort Moore, GA 31905-2102 Ph: (832) 264-1759

Reviews and Comments

Occupational Therapist in Fort Moore, GA

Matthew Black, OTD Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5241 23rd Infantry Regiment St Bldg 3410, Fort Moore, GA 31905 Phone: 541-226-7995
Christin Noel Boyd, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: Martin Army Community Hospital, 6600 Van Aalst Blvd., Fort Moore, GA 31905 Phone: 850-885-7777
Amelia Lea Butler, DSC, OTR/L, CHT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905 Phone: 908-329-8203
Susan B Williamson, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905 Phone: 706-545-9114

Etinosa Obadagbonyi, - Medicare Occupational Therapist in Fort Moore, GA