Madison Misenheimer, OTR/L is a medicare enrolled "Occupational Therapist" provider in Jefferson City, Tennessee. Her current practice location is
263 E Broadway Blvd, Jefferson City, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(865) 375-0880.
Madison Misenheimer is licensed to practice in Tennessee (license number 7416) 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 1790407104.
Healthcare Provider's Profile
| Full Name | Madison Misenheimer |
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| Gender | Female |
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| Speciality | Occupational Therapist |
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| Location | 263 E Broadway Blvd, Jefferson City, Tennessee |
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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: 1790407104
- Provider Enumeration Date: 09/13/2022
- Last Update Date: 12/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 3173993177
- Enrollment ID: I20230109002755
Medical Identifiers
Medical identifiers for Madison Misenheimer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790407104 | NPI | - | NPPES |
| 7416 | Other | TN | LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225X00000X | Occupational Therapist | 7416 (Tennessee) | 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. Madison Misenheimer allows following entities to bill medicare on her behalf.
| Provider Name | Jordan C Black |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1528569316
PECOS PAC ID: 5890117469
Enrollment ID: O20200629000595 |
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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. Madison Misenheimer 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 |
|---|
Madison Misenheimer, OTR/L
Po Box 608,
Bean Station, TN 37708-0608
Ph: () - | Madison Misenheimer, OTR/L
263 E Broadway Blvd,
Jefferson City, TN 37760-2810
Ph: (865) 375-0880 |
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