Dr Shamolie Nicole Wyckoff, MD is a medicare enrolled "Pain Medicine - Pain Medicine" physician in Hermitage, Tennessee. She went to Wright State University Boonshoft School Of Medicine and graduated in 2005 and has 19 years of diverse experience with area of expertise as Pain Management. She is a member of the group practice The Southeast Permanente Medical Group and her current practice location is
5651 Frist Blvd, Ste 712, Hermitage, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(615) 872-9966.
Dr Shamolie Nicole Wyckoff is licensed to practice in Tennessee (license number 48072) 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 1295872216.
Physician's Profile
| Full Name | Dr Shamolie Nicole Wyckoff |
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| Gender | Female |
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| Speciality | Pain Management |
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| Experience | 19 Years |
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| Location | 5651 Frist Blvd, Hermitage, Tennessee |
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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:
- Dr Shamolie Nicole Wyckoff attended and graduated from Wright State University Boonshoft School Of Medicine in 2005
NPI Data:
- NPI Number: 1295872216
- Provider Enumeration Date: 01/31/2007
- Last Update Date: 01/10/2022
Medicare PECOS Information:
- PECOS PAC ID: 7113067901
- Enrollment ID: I20180910000612
Medical Identifiers
Medical identifiers for Dr Shamolie Nicole Wyckoff such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295872216 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | P20277 (Maryland) | Secondary |
| 208VP0000X | Pain Medicine - Pain Medicine | 48072 (Tennessee) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| The Southeast Permanente Medical Group | 6204829013 | 576 |
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 Shamolie Nicole Wyckoff allows following entities to bill medicare on her behalf.
| Entity Name | The Southeast Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245266956
PECOS PAC ID: 6204829013
Enrollment ID: O20040407000370 |
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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 Shamolie Nicole Wyckoff 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 Shamolie Nicole Wyckoff, MD
15180 Old Hickory Blvd, #417,
Nashville, TN 37211-6503
Ph: () - | Dr Shamolie Nicole Wyckoff, MD
5651 Frist Blvd, Ste 712,
Hermitage, TN 37076-2054
Ph: (615) 872-9966 |
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