Amanda Didawick Russell, is a medicare enrolled "Physical Therapist" provider in Spring Lake, North Carolina. Her current practice location is
103 Sleepy Dr Ste G, Spring Lake, North Carolina. You can reach out to her office (for appointments etc.) via phone at
(910) 423-5622.
Amanda Didawick Russell is licensed to practice in North Carolina (license number P20626) 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 1124795802.
Healthcare Provider's Profile
| Full Name | Amanda Didawick Russell |
|---|
| Gender | Female |
|---|
| Speciality | Physical Therapist |
|---|
| Location | 103 Sleepy Dr Ste G, Spring Lake, North Carolina |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1124795802
- Provider Enumeration Date: 08/30/2021
- Last Update Date: 02/01/2023
Medicare PECOS Information:
- PECOS PAC ID: 3779005251
- Enrollment ID: I20250314000081
Medical Identifiers
Medical identifiers for Amanda Didawick Russell such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124795802 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | P20626 (North Carolina) | 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. Amanda Didawick Russell allows following entities to bill medicare on her behalf.
| Provider Name | Benefit Therapy Services Pllc |
|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
|---|
| Provider Identifiers | NPI Number: 1275994113
PECOS PAC ID: 7810282795
Enrollment ID: O20160817002493 |
|---|
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. Amanda Didawick Russell 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 |
|---|
Amanda Didawick Russell,
4602 Cumberland Rd,
Fayetteville, NC 28306-2412
Ph: (910) 423-5622 | Amanda Didawick Russell,
103 Sleepy Dr Ste G,
Spring Lake, NC 28390-3319
Ph: (910) 423-5622 |
Reviews and Comments