Mrs Kim Anderson, FNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Chicago, Illinois. Her current practice location is
2845 N Sheridan Road, Suite 907, Chicago, Illinois. You can reach out to her office (for appointments etc.) via phone at
(773) 295-0707.
Mrs Kim Anderson is licensed to practice in Illinois (license number 277001265) 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 1841729985.
Healthcare Provider's Profile
| Full Name | Mrs Kim Anderson |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 2845 N Sheridan Road, Chicago, Illinois |
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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: 1841729985
- Provider Enumeration Date: 06/10/2017
- Last Update Date: 04/20/2022
Medicare PECOS Information:
- PECOS PAC ID: 0042582835
- Enrollment ID: I20210311000508
Medical Identifiers
Medical identifiers for Mrs Kim Anderson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1841729985 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 832075 (Nevada) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 28194001A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 209017385 (Illinois) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 277001265 (Illinois) | 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. Mrs Kim Anderson allows following entities to bill medicare on her behalf.
| Entity Name | Fabian Carbonell Md Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578767935
PECOS PAC ID: 7416980172
Enrollment ID: O20050913001117 |
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| Entity Name | Paragon Clinical Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114139946
PECOS PAC ID: 7214034925
Enrollment ID: O20070515000051 |
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| Entity Name | New Leaf Wellness & Behavioral Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396328183
PECOS PAC ID: 7012303621
Enrollment ID: O20220407002091 |
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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. Mrs Kim Anderson 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 |
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Mrs Kim Anderson, FNP-BC
2845 N Sheridan Road, Suite 907,
Chicago, IL 60657
Ph: (773) 295-0707 | Mrs Kim Anderson, FNP-BC
2845 N Sheridan Road, Suite 907,
Chicago, IL 60657
Ph: (773) 295-0707 |
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