Kanesha Simmons Banks, is a medicare enrolled "Clinical Neuropsychologist" provider in Ft Worth, Texas. Her current practice location is
601 W Terrell Ave, Ft Worth, Texas. You can reach out to her office (for appointments etc.) via phone at
(817) 702-3100.
Kanesha Simmons Banks is licensed to practice in Texas (license number 17055) 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 1699449835.
Healthcare Provider's Profile
Full Name | Kanesha Simmons Banks |
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Gender | Female |
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Speciality | Clinical Neuropsychologist |
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Location | 601 W Terrell Ave, Ft Worth, Texas |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699449835
- Provider Enumeration Date: 08/02/2021
- Last Update Date: 07/28/2022
Medicare PECOS Information:
- PECOS PAC ID: 0648656413
- Enrollment ID: I20220930002031
Medical Identifiers
Medical identifiers for Kanesha Simmons Banks such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699449835 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | 38979 (Texas) | Secondary |
103G00000X | Clinical Neuropsychologist | 17055 (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. Kanesha Simmons Banks allows following entities to bill medicare on her behalf.
Entity Name | Acclaim Physician Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1780076562 PECOS PAC ID: 4587963582 Enrollment ID: O20160426000707 |
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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. Kanesha Simmons Banks 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 |
Kanesha Simmons Banks, 7400 Merton Minter St, San Antonio, TX 78229-4404 Ph: (210) 617-5300 | Kanesha Simmons Banks, 601 W Terrell Ave, Ft Worth, TX 76104-3243 Ph: (817) 702-3100 |
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