Carly Jessica Knobloch, PMHNP is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Bixby, Oklahoma. She graduated from medical school in 2021 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Prophylaxis Healthcare Llc and her current practice location is
11911 S Memorial Dr, Bixby, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 943-3790.
Carly Jessica Knobloch is licensed to practice in Louisiana (license number RN150943) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1700454287.
Physician's Profile
| Full Name | Carly Jessica Knobloch |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 11911 S Memorial Dr, Bixby, Oklahoma |
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| Accepts Medicare Assignments | Yes. She 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:
- Carly Jessica Knobloch graduated from medical school in 2021
NPI Data:
- NPI Number: 1700454287
- Provider Enumeration Date: 06/11/2021
- Last Update Date: 12/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 2860871936
- Enrollment ID: I20220620002041
Medical Identifiers
Medical identifiers for Carly Jessica Knobloch such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1700454287 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | RN150943 (Louisiana) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Prophylaxis Healthcare Llc | 3072784289 | 26 |
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. Carly Jessica Knobloch allows following entities to bill medicare on her behalf.
| Entity Name | Prophylaxis Healthcare Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538453923
PECOS PAC ID: 3072784289
Enrollment ID: O20110920000575 |
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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. Carly Jessica Knobloch 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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Carly Jessica Knobloch, PMHNP
Po Box 334,
Bixby, OK 74008-0334
Ph: (918) 943-3790 | Carly Jessica Knobloch, PMHNP
11911 S Memorial Dr,
Bixby, OK 74008-2030
Ph: (918) 943-3790 |
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