Dr Jose Nellikappallil, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Fort Worth, Texas. His current practice location is
1500 S Main St, Fort Worth, Texas. You can reach out to his office (for appointments etc.) via phone at
(817) 702-8840.
Dr Jose Nellikappallil is licensed to practice in * (Not Available) (license number ) 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 1124777255.
Physician's Profile
| Full Name | Dr Jose Nellikappallil |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 1500 S Main St, Fort Worth, Texas |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1124777255
- Provider Enumeration Date: 03/23/2022
- Last Update Date: 11/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 5698213791
- Enrollment ID: I20240821000111
Medical Identifiers
Medical identifiers for Dr Jose Nellikappallil such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1124777255 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207P00000X | Emergency Medicine | V2180 (Texas) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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 Jose Nellikappallil allows following entities to bill medicare on his behalf.
| Entity Name | Integrative Emergency Services Physician Group Pa |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1285922542 PECOS PAC ID: 0749447936 Enrollment ID: O20120130000932 |
|---|
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 Jose Nellikappallil 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 |
Dr Jose Nellikappallil, MD 1500 S Main St, Fort Worth, TX 76104-4917 Ph: (817) 702-8840 | Dr Jose Nellikappallil, MD 1500 S Main St, Fort Worth, TX 76104-4917 Ph: (817) 702-8840 |
Reviews and Comments