Dr James Prentice Derossitt, MD is a medicare enrolled "Obstetrics & Gynecology" physician in West Memphis, Arkansas. His current practice location is
210 S Rhodes, West Memphis, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(870) 732-5448.
Dr James Prentice Derossitt is licensed to practice in Arkansas (license number C5392) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1356317507.
Physician's Profile
| Full Name | Dr James Prentice Derossitt |
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| Gender | Male |
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| Speciality | Obstetrics & Gynecology |
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| Location | 210 S Rhodes, West Memphis, Arkansas |
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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: 1356317507
- Provider Enumeration Date: 02/27/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 7719981331
- Enrollment ID: I20120126000785
Medical Identifiers
Medical identifiers for Dr James Prentice Derossitt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1356317507 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | C5392 (Arkansas) | 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. Dr James Prentice Derossitt allows following entities to bill medicare on his behalf.
| Entity Name | Forrest City Clinic Company Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821293051
PECOS PAC ID: 1557457447
Enrollment ID: O20071024000213 |
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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. Dr James Prentice Derossitt 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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Dr James Prentice Derossitt, MD
Po Box 1687,
West Memphis, AR 72303-1687
Ph: (870) 732-5448 | Dr James Prentice Derossitt, MD
210 S Rhodes,
West Memphis, AR 72301-1687
Ph: (870) 732-5448 |
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