Keitra Thompson, CRNP in Bridgeport, CT - Medicare Nurse Practitioner

Keitra Thompson, CRNP is a medicare enrolled "Nurse Practitioner - Family" in Bridgeport, Connecticut. Her current practice location is 64 Black Rock Ave, Bridgeport, Connecticut. You can reach out to her office (for appointments etc.) via phone at (203) 579-5000.

Keitra Thompson is licensed to practice in Connecticut (license number 8742) 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 1063942555.

Contact Information

	Keitra Thompson, CRNP
	64 Black Rock Ave, Bridgeport, CT 06605-1200
	(203) 579-5000
	Not Available

Map and Direction

Provider's Profile

Full Name	Keitra Thompson
Gender	Female
Speciality	Nurse Practitioner - Family
Location	64 Black Rock Ave, Bridgeport, Connecticut
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1063942555
Provider Enumeration Date: 06/15/2017
Last Update Date: 05/10/2020

Medicare PECOS Information:

PECOS PAC ID: 8527332022
Enrollment ID: I20201211000219

Medical Identifiers

Medical identifiers for Keitra Thompson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1063942555	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	RN1050784 (District Of Columbia)	Secondary
363LF0000X	Nurse Practitioner - Family	R214567 (Maryland)	Secondary
363LF0000X	Nurse Practitioner - Family	APRNCNP021660 (Ohio)	Secondary
363LF0000X	Nurse Practitioner - Family	8742 (Connecticut)	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. Keitra Thompson allows following entities to bill medicare on her behalf.

Entity Name	Optimus Health Care Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669445946 PECOS PAC ID: 9335051580 Enrollment ID: O20031105000254

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. Keitra Thompson 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
Keitra Thompson, CRNP 90 Knob Hill Dr, Hamden, CT 06518-2428 Ph: () -	Keitra Thompson, CRNP 64 Black Rock Ave, Bridgeport, CT 06605-1200 Ph: (203) 579-5000

Reviews and Comments

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Esther M Mervil, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 471 Barnum Ave, Bridgeport, CT 06608 Phone: 203-333-6864 Fax: 203-332-0376
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Keitra Thompson, CRNP - Medicare Nurse Practitioner in Bridgeport, CT