Ms Kathleen P Fantozzi, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" physician in Manchester, New Hampshire. Her current practice location is
1590 Union St, Manchester, New Hampshire. You can reach out to her office (for appointments etc.) via phone at
(603) 860-8905.
Ms Kathleen P Fantozzi is licensed to practice in New Hampshire (license number 2020015527) 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 1861002701.
Physician's Profile
| Full Name | Ms Kathleen P Fantozzi |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 1590 Union St, Manchester, New Hampshire |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1861002701
- Provider Enumeration Date: 08/05/2020
- Last Update Date: 09/04/2020
Medicare PECOS Information:
- PECOS PAC ID: 6406265313
- Enrollment ID: I20210505002684
Medical Identifiers
Medical identifiers for Ms Kathleen P Fantozzi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1861002701 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | 2020015527 (New Hampshire) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 2020015527 (New Hampshire) | 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. Ms Kathleen P Fantozzi allows following entities to bill medicare on her behalf.
| Entity Name | Minuteclinic Diagnostic Of New Hampshire Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1477894673 PECOS PAC ID: 8628206968 Enrollment ID: O20140114001041 |
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| Entity Name | Medcare Nh Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770250318 PECOS PAC ID: 1456758572 Enrollment ID: O20210916000452 |
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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. Ms Kathleen P Fantozzi 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 |
Ms Kathleen P Fantozzi, FNP-BC 1590 Union St, Manchester, NH 03104-1768 Ph: (603) 860-8905 | Ms Kathleen P Fantozzi, FNP-BC 1590 Union St, Manchester, NH 03104-1768 Ph: (603) 860-8905 |
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