Fred Boothby, CNP in Allegan, MI - Medicare Nurse Practitioner

Fred Boothby, CNP is a medicare enrolled "Nurse Practitioner" in Allegan, Michigan. His current practice location is 3285 122nd Ave, P.o. Drawer 130, Allegan, Michigan. You can reach out to his office (for appointments etc.) via phone at (269) 673-6617.

Fred Boothby is licensed to practice in Michigan (license number 4704142595) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1962483271.

Contact Information

	Fred Boothby, CNP
	3285 122nd Ave, P.o. Drawer 130, Allegan, MI 49010-9511
	(269) 673-6617
	(269) 673-2738

Map and Direction

Provider's Profile

Full Name	Fred Boothby
Gender	Male
Speciality	Nurse Practitioner
Location	3285 122nd Ave, Allegan, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1962483271
Provider Enumeration Date: 11/14/2005
Last Update Date: 01/18/2008

Medicare PECOS Information:

PECOS PAC ID: 4587602156
Enrollment ID: I20050422001137

Medical Identifiers

Medical identifiers for Fred Boothby such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1962483271	NPI	-	NPPES
4699274	Medicaid	MI
5008704740	Other	MI	BCBS

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	4704142595 (Michigan)	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. Fred Boothby allows following entities to bill medicare on his behalf.

Entity Name	Pine Rest Christian Mental Health Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467463604 PECOS PAC ID: 4981506508 Enrollment ID: O20041103000525

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. Fred Boothby 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
Fred Boothby, CNP 3285 122nd Ave, P.o. Drawer 130, Allegan, MI 49010-9511 Ph: (269) 673-6617	Fred Boothby, CNP 3285 122nd Ave, P.o. Drawer 130, Allegan, MI 49010-9511 Ph: (269) 673-6617

Reviews and Comments

Nurse Practitioner Nurses in Allegan, MI

Amber Marie Perez, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 226 Knapp St, Allegan, MI 49010 Phone: 660-631-2867 Fax: 269-355-1874
Amy Lynn Shubnell, F.N.P. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 305 Thomas St, Allegan, MI 49010 Phone: 269-673-2179 Fax: 269-673-6992
Erin E Beauchamp, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3285 122nd Ave, Allegan, MI 49010 Phone: 269-673-6617 Fax: 269-673-2738
Ms. Melanie Powers Low, N.P. Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Perrigo Medical Center, 325 Eastern Ave, Allegan, MI 49010 Phone: 269-673-9000 Fax: 269-673-9027
Kevin Maynard Cooper, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 555 Linn St, Allegan, MI 49010 Phone: 269-686-5800
Cassie L Vandervelden, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 551 Linn St, Ste. 150, Allegan, MI 49010 Phone: 269-686-5800 Fax: 269-686-5899
Tracy Vanden Bosch, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 551 Linn St, Suite 150, Allegan, MI 49010 Phone: 269-686-5800 Fax: 269-686-5899

Fred Boothby, CNP - Medicare Nurse Practitioner in Allegan, MI