Dr Stacy L Kanagawa, DO is a medicare enrolled "Pediatrics" physician in Nixa, Missouri. Her current practice location is
940 W Mount Vernon St, Suite 220, Nixa, Missouri. You can reach out to her office (for appointments etc.) via phone at
(417) 724-5437.
Dr Stacy L Kanagawa is licensed to practice in Missouri (license number 2002009355) 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 1861438475.
Physician's Profile
| Full Name | Dr Stacy L Kanagawa |
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| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 940 W Mount Vernon St, Nixa, Missouri |
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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: 1861438475
- Provider Enumeration Date: 06/21/2006
- Last Update Date: 05/13/2013
Medicare PECOS Information:
- PECOS PAC ID: 1557445277
- Enrollment ID: I20080219000785
Medical Identifiers
Medical identifiers for Dr Stacy L Kanagawa such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861438475 | NPI | - | NPPES |
| 168192003 | Medicaid | AR | |
| 208341206 | Medicaid | MO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 2002009355 (Missouri) | 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 Stacy L Kanagawa allows following entities to bill medicare on her behalf.
| Entity Name | Mercy Clinic Springfield Communities |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972771657
PECOS PAC ID: 7416865845
Enrollment ID: O20031218000354 |
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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 Stacy L Kanagawa 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 Stacy L Kanagawa, DO
Po Box 2580,
Springfield, MO 65801-2580
Ph: (417) 829-4620 | Dr Stacy L Kanagawa, DO
940 W Mount Vernon St, Suite 220,
Nixa, MO 65714-9609
Ph: (417) 724-5437 |
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