Brooklyn Rae Fort, NP is a medicare enrolled "Dermatology" in Springfield, Missouri. She graduated from nursing school in 2023 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Mike Swann, Md, Llc and her current practice location is
3850 S National Ave Ste 705, Springfield, Missouri. You can reach out to her office (for appointments etc.) via phone at
(417) 888-0858.
Brooklyn Rae Fort is licensed to practice in Missouri (license number 2024009420) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1114655214.
Provider's Profile
| Full Name | Brooklyn Rae Fort |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 3850 S National Ave Ste 705, Springfield, Missouri |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Brooklyn Rae Fort graduated from nursing school in 2023
NPI Data:
- NPI Number: 1114655214
- Provider Enumeration Date: 08/08/2022
- Last Update Date: 01/17/2025
Medicare PECOS Information:
- PECOS PAC ID: 0648719757
- Enrollment ID: I20240903001728
Medical Identifiers
Medical identifiers for Brooklyn Rae Fort such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1114655214 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 2024009420 (Missouri) | Secondary |
| 207N00000X | Dermatology | 2024009420 (Missouri) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mike Swann, Md, Llc | 0941346068 | 9 |
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. Brooklyn Rae Fort allows following entities to bill medicare on her behalf.
| Entity Name | Mike Swann, Md, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1689907081
PECOS PAC ID: 0941346068
Enrollment ID: O20091002000604 |
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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. Brooklyn Rae Fort 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 |
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Brooklyn Rae Fort, NP
3850 S National Ave Ste 705,
Springfield, MO 65807-5239
Ph: (417) 888-0858 | Brooklyn Rae Fort, NP
3850 S National Ave Ste 705,
Springfield, MO 65807-5239
Ph: (417) 888-0858 |
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