Karissa Ann Pavelka Simon, MS, OTR/L is a medicare enrolled "Student In An Organized Health Care Education/training Program" provider in Manlius, New York. Her current practice location is
8092 Verbeck Dr, Manlius, New York. You can reach out to her office (for appointments etc.) via phone at
(443) 752-9952.
Karissa Ann Pavelka Simon is licensed to practice in * (Not Available) (license number ) 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 1184980310.
Healthcare Provider's Profile
| Full Name | Karissa Ann Pavelka Simon |
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| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 8092 Verbeck Dr, Manlius, New York |
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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: 1184980310
- Provider Enumeration Date: 04/02/2012
- Last Update Date: 10/23/2022
Medicare PECOS Information:
- PECOS PAC ID: 5092246827
- Enrollment ID: I20241004000465
Medical Identifiers
Medical identifiers for Karissa Ann Pavelka Simon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184980310 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | 020867 (New York) | Secondary |
| 225X00000X | Occupational Therapist | 07208 (Maryland) | Secondary |
| 225X00000X | Occupational Therapist | 46TR00816700 (New Jersey) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Karissa Ann Pavelka Simon allows following entities to bill medicare on her behalf.
| Provider Name | Fox Rehabilitation Services Inc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1326092503
PECOS PAC ID: 0143133009
Enrollment ID: O20150303000554 |
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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. Karissa Ann Pavelka Simon 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 |
|---|
Karissa Ann Pavelka Simon, MS, OTR/L
8092 Verbeck Dr,
Manlius, NY 13104-9312
Ph: (443) 752-9952 | Karissa Ann Pavelka Simon, MS, OTR/L
8092 Verbeck Dr,
Manlius, NY 13104-9312
Ph: (443) 752-9952 |
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