Kanon Broussard, in Huntersville, NC - Medicare Physical Therapist Provider

Kanon Broussard, is a medicare enrolled "Physical Therapist" provider in Huntersville, North Carolina. His current practice location is 16405 Northcross Dr, Suite G-2, Huntersville, North Carolina. You can reach out to his office (for appointments etc.) via phone at (866) 214-9644.

Kanon Broussard is licensed to practice in Louisiana (license number 09393) 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 1639521172.

Contact Information

	Kanon Broussard,
	16405 Northcross Dr, Suite G-2, Huntersville, NC 28078-5091
	(866) 214-9644
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Kanon Broussard
Gender	Male
Speciality	Physical Therapist
Location	16405 Northcross Dr, Huntersville, 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: 1639521172
Provider Enumeration Date: 07/08/2016
Last Update Date: 07/08/2016

Medicare PECOS Information:

PECOS PAC ID: 6901246156
Enrollment ID: I20240503003484

Medical Identifiers

Medical identifiers for Kanon Broussard such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639521172	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
225100000X	Physical Therapist	09393 (Louisiana)	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. Kanon Broussard allows following entities to bill medicare on his behalf.

Provider Name	Synergy Care Southeast, Llc
Provider Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Provider Identifiers	NPI Number: 1891156055 PECOS PAC ID: 6204079163 Enrollment ID: O20160722001624

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. Kanon Broussard 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
Kanon Broussard, 16405 Northcross Dr, Suite G-2, Huntersville, NC 28078-5091 Ph: (866) 214-9644	Kanon Broussard, 16405 Northcross Dr, Suite G-2, Huntersville, NC 28078-5091 Ph: (866) 214-9644

Reviews and Comments

Physical Therapist in Huntersville, NC

Meghan Catherine Cesarz, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 13245 Reese Blvd W Ste 100, Huntersville, NC 28078 Phone: 704-316-5096
Pranamixpt, Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 17422 Glassfield Dr, Huntersville, NC 28078 Phone: 808-463-4663
Natalie Proffit Mcaveney, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 13245 Reece Blvd W Ste 100, Huntersville, NC 28078 Phone: 704-316-5096
Return 2 Play Llc Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9820 Northcross Center Ct Ste 194, Huntersville, NC 28078 Phone: 704-559-9287
Debra Myhr, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 14330 Oakhill Park Ln Ste 115, Huntersville, NC 28078 Phone: 704-316-1265 Fax: 704-316-1266
David D Newstead, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 16405 Northcross Dr, Suite G-2, Huntersville, NC 28078 Phone: 704-439-3406
Cotrease Lawson, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 16405 Northcross Dr, Ste G-2, Huntersville, NC 28078 Phone: 704-439-3403

Kanon Broussard, - Medicare Physical Therapist in Huntersville, NC