Mrs Takedria Mingo-berry, FNP-BC is a medicare enrolled "Nurse Practitioner" physician in Novi, Michigan. Her current practice location is
41800 W 11 Mile Rd Ste 109751, Novi, Michigan. You can reach out to her office (for appointments etc.) via phone at
(240) 660-1220.
Mrs Takedria Mingo-berry is licensed to practice in Missouri (license number 2018035915) 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 1255816591.
Physician's Profile
| Full Name | Mrs Takedria Mingo-berry |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 41800 W 11 Mile Rd Ste 109751, Novi, 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: 1255816591
- Provider Enumeration Date: 10/02/2018
- Last Update Date: 09/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 6204175797
- Enrollment ID: I20190227002733
Medical Identifiers
Medical identifiers for Mrs Takedria Mingo-berry such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255816591 | NPI | - | NPPES |
| 1255816591 | Other | MO | NPI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 2011034040 (Missouri) | Secondary |
| 207Q00000X | Family Medicine | 2018035915 (Missouri) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 2018035915 (Missouri) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 53-81402-052 (Kansas) | Secondary |
| 363L00000X | Nurse Practitioner | 2018035915 (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. Mrs Takedria Mingo-berry allows following entities to bill medicare on her behalf.
| Entity Name | Barnes Health Care Management Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396999686
PECOS PAC ID: 1759441447
Enrollment ID: O20081126000113 |
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| Entity Name | Barnes Health Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275219073
PECOS PAC ID: 9739541301
Enrollment ID: O20230814002158 |
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| Entity Name | Theoria Medical |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609362375
PECOS PAC ID: 5395098339
Enrollment ID: O20240919002593 |
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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 Takedria Mingo-berry 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 |
|---|
Mrs Takedria Mingo-berry, FNP-BC
18006 E Union School Rd,
Independence, MO 64058-1975
Ph: (816) 217-7659 | Mrs Takedria Mingo-berry, FNP-BC
41800 W 11 Mile Rd Ste 109751,
Novi, MI 48375-1872
Ph: (240) 660-1220 |
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