Damaris W Kongo, REGISTERED NURSE is a medicare enrolled "Registered Nurse - Community Health" in Ludlow, Massachusetts. She graduated from nursing school in 2011 and has 14 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Center For Human Development, Inc. and her current practice location is
39 Allison Ln, Ludlow, Massachusetts. You can reach out to her office (for appointments etc.) via phone at
(413) 530-7318.
Damaris W Kongo is licensed to practice in Massachusetts (license number RN270089) 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 1376114009.
Provider's Profile
| Full Name | Damaris W Kongo |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 14 Years |
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| Location | 39 Allison Ln, Ludlow, Massachusetts |
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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:
- Damaris W Kongo graduated from nursing school in 2011
NPI Data:
- NPI Number: 1376114009
- Provider Enumeration Date: 07/03/2021
- Last Update Date: 01/27/2024
Medicare PECOS Information:
- PECOS PAC ID: 3779977707
- Enrollment ID: I20220308001367
Medical Identifiers
Medical identifiers for Damaris W Kongo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1376114009 | NPI | - | NPPES |
| S31366290 | Other | MA | DRIVERS LISENCE |
| 00000000000 | Other | MA | SOCIAL SECURITY |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163WC1500X | Registered Nurse - Community Health | RN270089 (Massachusetts) | Primary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | RN270089 (Massachusetts) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Center For Human Development, Inc. | 7618950874 | 74 |
| | |
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. Damaris W Kongo allows following entities to bill medicare on her behalf.
| Entity Name | Center For Human Development, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912099219
PECOS PAC ID: 7618950874
Enrollment ID: O20041129000514 |
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| Entity Name | Springfield Medical Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992589535
PECOS PAC ID: 5496198848
Enrollment ID: O20240213001802 |
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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. Damaris W Kongo 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 |
|---|
Damaris W Kongo, REGISTERED NURSE
39 Allison Ln,
Ludlow, MA 01056-9201
Ph: (413) 530-7318 | Damaris W Kongo, REGISTERED NURSE
39 Allison Ln,
Ludlow, MA 01056-9201
Ph: (413) 530-7318 |
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