Bomnara Degroot, FNP is a medicare enrolled "Nurse Practitioner - Family" physician in Modesto, California. Her current practice location is
1444 Florida Ave Ste 202, Modesto, California. You can reach out to her office (for appointments etc.) via phone at
(209) 524-1264.
Bomnara Degroot is licensed to practice in California (license number 95012814) 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 1578105789.
Physician's Profile
Full Name | Bomnara Degroot |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 1444 Florida Ave Ste 202, Modesto, California |
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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: 1578105789
- Provider Enumeration Date: 10/09/2019
- Last Update Date: 09/02/2020
Medicare PECOS Information:
- PECOS PAC ID: 6406280411
- Enrollment ID: I20191230000378
Medical Identifiers
Medical identifiers for Bomnara Degroot such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1578105789 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 95012814 (California) | Secondary |
363LF0000X | Nurse Practitioner - Family | 95012814 (California) | 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. Bomnara Degroot allows following entities to bill medicare on her behalf.
Entity Name | First Choice Physician Partners |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1104183052 PECOS PAC ID: 0941465322 Enrollment ID: O20120710000480 |
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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. Bomnara Degroot 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 |
Bomnara Degroot, FNP 1444 Florida Ave Ste 202, Modesto, CA 95350-4400 Ph: () - | Bomnara Degroot, FNP 1444 Florida Ave Ste 202, Modesto, CA 95350-4400 Ph: (209) 524-1264 |
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