Mrs Ashley Marie Fugate, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" physician in Niles, Michigan. Her current practice location is
2002 S 11th St, Niles, Michigan. You can reach out to her office (for appointments etc.) via phone at
(269) 687-0200.
Mrs Ashley Marie Fugate is licensed to practice in Michigan (license number 4704268183) 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 1104281583.
Physician's Profile
| Full Name | Mrs Ashley Marie Fugate |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 2002 S 11th St, Niles, Michigan |
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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: 1104281583
- Provider Enumeration Date: 12/29/2015
- Last Update Date: 06/20/2024
Medicare PECOS Information:
- PECOS PAC ID: 6002115045
- Enrollment ID: I20160426001830
Medical Identifiers
Medical identifiers for Mrs Ashley Marie Fugate such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104281583 | NPI | - | NPPES |
| 201368160 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 28181495A (Indiana) | Secondary |
| 363L00000X | Nurse Practitioner | 4704268183 (Michigan) | Secondary |
| 363L00000X | Nurse Practitioner | 71006097A (Indiana) | Secondary |
| 363LA2200X | Nurse Practitioner - Adult Health | 71006097A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 71006097A (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 4704268183 (Michigan) | 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. Mrs Ashley Marie Fugate allows following entities to bill medicare on her behalf.
| Entity Name | Healthlinc Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528262581
PECOS PAC ID: 7618929373
Enrollment ID: O20050210000929 |
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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. Mrs Ashley Marie Fugate 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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Mrs Ashley Marie Fugate, FNP-BC
2002 S 11th St,
Niles, MI 49120-4074
Ph: () - | Mrs Ashley Marie Fugate, FNP-BC
2002 S 11th St,
Niles, MI 49120-4074
Ph: (269) 687-0200 |
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