San Thawalanthanne, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Longwood, Florida. He graduated from healthcare school in 2023 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Tampa Neuropsychiatry and his current practice location is
2290 N Ronald Reagan Blvd Ste 116, Longwood, Florida. You can reach out to his office (for appointments etc.) via phone at
(407) 215-0095.
San Thawalanthanne is licensed to practice in Florida (license number 11031100) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1275397622.
Healthcare Provider's Profile
| Full Name | San Thawalanthanne |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 3 Years |
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| Location | 2290 N Ronald Reagan Blvd Ste 116, Longwood, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- San Thawalanthanne graduated from medical school in 2023
NPI Data:
- NPI Number: 1275397622
- Provider Enumeration Date: 02/07/2024
- Last Update Date: 11/04/2024
Medicare PECOS Information:
- PECOS PAC ID: 7618418484
- Enrollment ID: I20240919002730
Medical Identifiers
Medical identifiers for San Thawalanthanne such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1275397622 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 11031100 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Tampa Neuropsychiatry | 4385928647 | 15 |
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. San Thawalanthanne allows following entities to bill medicare on his behalf.
| Entity Name | Impower, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104910868
PECOS PAC ID: 6507924883
Enrollment ID: O20081015000736 |
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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. San Thawalanthanne 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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San Thawalanthanne,
1000 S Lake Dr,
Clearwater, FL 33756-4415
Ph: (815) 451-2897 | San Thawalanthanne,
2290 N Ronald Reagan Blvd Ste 116,
Longwood, FL 32750-3534
Ph: (407) 215-0095 |
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