Belinda Fomba, - Medicare Nurse Practitioner in Fort Defiance, AZ

Belinda Fomba, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Fort Defiance, Arizona. Her current practice location is Corner Of Route N12 And N7, Fort Defiance, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 729-8000.

Belinda Fomba is licensed to practice in Arizona (license number 219337) 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 1194434738.

Contact Information

Belinda Fomba,
Corner Of Route N12 And N7,
Fort Defiance, AZ 86504-0649
(928) 729-8000
Not Available

Map and Direction




Provider's Profile

Full NameBelinda Fomba
GenderFemale
SpecialityNurse Practitioner - Psychiatric/mental Health
LocationCorner Of Route N12 And N7, Fort Defiance, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1194434738
  • Provider Enumeration Date: 11/22/2022
  • Last Update Date: 05/04/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2264898816
  • Enrollment ID: I20230524000491

Medical Identifiers

Medical identifiers for Belinda Fomba such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1194434738NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse 219337 (Arizona)Secondary
363LP0808XNurse Practitioner - Psychiatric/mental Health 219337 (Arizona)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. Belinda Fomba allows following entities to bill medicare on her behalf.
Entity NameThe Fort Defiance Indian Hospital Board, Incorporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477876639
PECOS PAC ID: 0941336697
Enrollment ID: O20100429001153

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. Belinda Fomba 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 AddressPractice Location Address
Belinda Fomba,
Po Box 649,
Fort Defiance, AZ 86504-0649

Ph: () -
Belinda Fomba,
Corner Of Route N12 And N7,
Fort Defiance, AZ 86504-0649

Ph: (928) 729-8000

Reviews and Comments


Nurse Practitioner Nurses in Fort Defiance, AZ

Rosemary Josephine Bolza, CNM
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: Intersection Of Highways 7 And 12, Fort Defiance, AZ 86504
Phone: 928-729-8775    
Mrs. Patricia Nadurak,
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: Corner Of N12 And N8, Fort Defiance, AZ 86504
Phone: 928-729-8000    
Jamie S Adams,
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: Corner Routes N7 & N12, Fort Defiance, AZ 86504
Phone: 928-729-8000    
Kathryn Barron, NP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504
Phone: 928-729-8821    
June Ellen Rhoda, APRN-NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: Corner Of Route N12 And N7, Fort Defiance, AZ 86504
Phone: 928-729-8000    
Melonie I Blancaneaux,
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: Tseshootsooi Medical Center, Corner Of Route N12 And N7, Fort Defiance, AZ 86504
Phone: 928-729-8587    
Ms. Jean Proper, FNP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: Corner Of Route N12 & N7, Fort Defiance, AZ 86504
Phone: 928-729-8000    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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