Amber Leia Waggoner, NP in Portland, TX - Medicare Nurse Practitioner

Amber Leia Waggoner, NP is a medicare enrolled "Nurse Practitioner - Family" in Portland, Texas. Her current practice location is 2413 Memorial Pkwy, Portland, Texas. You can reach out to her office (for appointments etc.) via phone at (361) 643-4546.

Amber Leia Waggoner is licensed to practice in Texas (license number 1145675) 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 1083483713.

Contact Information

	Amber Leia Waggoner, NP
	2413 Memorial Pkwy, Portland, TX 78374-3209
	(361) 643-4546
	(361) 758-2137

Map and Direction

Provider's Profile

Full Name	Amber Leia Waggoner
Gender	Female
Speciality	Nurse Practitioner - Family
Location	2413 Memorial Pkwy, Portland, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083483713
Provider Enumeration Date: 12/21/2023
Last Update Date: 01/23/2024

Medicare PECOS Information:

PECOS PAC ID: 3779934518
Enrollment ID: I20240105003018

Medical Identifiers

Medical identifiers for Amber Leia Waggoner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083483713	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	1145675 (Texas)	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. Amber Leia Waggoner allows following entities to bill medicare on her behalf.

Entity Name	Wellmed Medical Group Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437156486 PECOS PAC ID: 4880657386 Enrollment ID: O20041105000519

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. Amber Leia Waggoner 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
Amber Leia Waggoner, NP 2413 Memorial Pkwy, Portland, TX 78374-3209 Ph: (361) 643-4546	Amber Leia Waggoner, NP 2413 Memorial Pkwy, Portland, TX 78374-3209 Ph: (361) 643-4546

Reviews and Comments

Nurse Practitioner Nurses in Portland, TX

Micah Flores, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2413 Memorial Pkwy, Portland, TX 78374 Phone: 361-643-4546 Fax: 361-758-2137
Mrs. Samantha Jo Wright, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 616 Elm St, Portland, TX 78374 Phone: 361-977-2059 Fax: 361-977-2047
Marka Jane Dredla, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 277 Buddy Ganem Dr Ste A, Portland, TX 78374 Phone: 361-777-3900 Fax: 361-413-0274
Matthew Kern, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 125 Northshore Blvd, Portland, TX 78374 Phone: 361-480-0334
Mrs. Gloria Perales Solis, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1500 Wildcat Dr Ste C, Portland, TX 78374 Phone: 361-643-9800 Fax: 361-643-5112
Kerrie Hogin Baker, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2413 Memorial Pkwy, Portland, TX 78374 Phone: 361-643-4546

Amber Leia Waggoner, NP - Medicare Nurse Practitioner in Portland, TX