Clede Kemayu, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Lucas, Texas. Her current practice location is
1200 Excellence Dr, Lucas, Texas. You can reach out to her office (for appointments etc.) via phone at
(469) 328-1102.
Clede Kemayu is licensed to practice in Texas (license number 1060445) 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 1063155018.
Provider's Profile
| Full Name | Clede Kemayu |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 1200 Excellence Dr, Lucas, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1063155018
- Provider Enumeration Date: 04/18/2022
- Last Update Date: 04/18/2022
Medicare PECOS Information:
- PECOS PAC ID: 9335662535
- Enrollment ID: I20250328000904
Medical Identifiers
Medical identifiers for Clede Kemayu such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063155018 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 1060445 (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. Clede Kemayu allows following entities to bill medicare on her behalf.
| Entity Name | Mind Vibe Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538933080
PECOS PAC ID: 1153842760
Enrollment ID: O20250311001871 |
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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. Clede Kemayu 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 |
|---|
Clede Kemayu,
1200 Excellence Dr,
Lucas, TX 75098-1848
Ph: (469) 328-1102 | Clede Kemayu,
1200 Excellence Dr,
Lucas, TX 75098-1848
Ph: (469) 328-1102 |
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