Nikki Ilona Broussard, CRNP in Dothan, AL - Medicare Internal Medicine

Nikki Ilona Broussard, CRNP is a medicare enrolled "Internal Medicine - Nephrology" physician in Dothan, Alabama. Her current practice location is 207 Haven Dr, Dothan, Alabama. You can reach out to her office (for appointments etc.) via phone at (337) 793-3319.

Nikki Ilona Broussard is licensed to practice in Alabama (license number 1-121127) 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 1043034580.

Contact Information

	Nikki Ilona Broussard, CRNP
	207 Haven Dr, Dothan, AL 36301-2919
	(337) 793-3319
	Not Available

Map and Direction

Physician's Profile

Full Name	Nikki Ilona Broussard
Gender	Female
Speciality	Internal Medicine - Nephrology
Location	207 Haven Dr, Dothan, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043034580
Provider Enumeration Date: 11/12/2024
Last Update Date: 11/12/2024

Medicare PECOS Information:

PECOS PAC ID: 8628599107
Enrollment ID: I20250313000973

Medical Identifiers

Medical identifiers for Nikki Ilona Broussard such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043034580	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RN0300X	Internal Medicine - Nephrology	1-121127 (Alabama)	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. Nikki Ilona Broussard allows following entities to bill medicare on her behalf.

Entity Name	Dothan Hypertension Nephrology Associates
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1013018407 PECOS PAC ID: 5991746661 Enrollment ID: O20050822000909

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. Nikki Ilona Broussard 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
Nikki Ilona Broussard, CRNP 207 Haven Dr, Dothan, AL 36301-2919 Ph: (334) 793-3319	Nikki Ilona Broussard, CRNP 207 Haven Dr, Dothan, AL 36301-2919 Ph: (337) 793-3319

Reviews and Comments

Internal Medicine Doctors in Dothan, AL

Parks Winfield Pratt Iii, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 4300 W Main St, Suite 102, Dothan, AL 36305 Phone: 334-793-9564 Fax: 334-671-8907
Mr. Rodney K Beauchamp, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 200 Parkwest Cir Ste 2, Dothan, AL 36303 Phone: 334-699-2004
Brian Reynolds Sinclair, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 1450 Ross Clark Cir Ste 400, Dothan, AL 36301 Phone: 334-305-0400 Fax: 334-305-0401
Dr. Olawale Mayokun Osunsanya, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 1763 E Main St, Dothan, AL 36301 Phone: 334-793-3319 Fax: 334-793-2291
Jeffrey John Crittenden, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 480 Honeysuckle Rd, Dothan, AL 36305 Phone: 334-836-1212 Fax: 334-836-1888
Dr. Venkat R Nimmagadda, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 207 Haven Dr, Dothan, AL 36301 Phone: 334-793-3319 Fax: 334-793-2291

Nikki Ilona Broussard, CRNP - Medicare Internal Medicine in Dothan, AL