Jalisa White, NNP is a medicare enrolled "Nurse Practitioner - Neonatal, Critical Care" in Edwardsville, Kansas. Her current practice location is
612 S 6th St, Edwardsville, Kansas. You can reach out to her office (for appointments etc.) via phone at
(913) 309-9281.
Jalisa White is licensed to practice in Kansas (license number 53-81350-041) 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 1497486567.
Provider's Profile
| Full Name | Jalisa White |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Neonatal, Critical Care |
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| Location | 612 S 6th St, Edwardsville, Kansas |
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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: 1497486567
- Provider Enumeration Date: 06/21/2022
- Last Update Date: 10/31/2022
Medicare PECOS Information:
- PECOS PAC ID: 0648649137
- Enrollment ID: I20221205002348
Medical Identifiers
Medical identifiers for Jalisa White such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1497486567 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163WN0002X | Registered Nurse - Neonatal Intensive Care | 13-131827-041 (Kansas) | Secondary |
| 363LN0005X | Nurse Practitioner - Neonatal, Critical Care | 53-81350-041 (Kansas) | 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. Jalisa White allows following entities to bill medicare on her behalf.
| Entity Name | Kansas University Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003858333
PECOS PAC ID: 8921911587
Enrollment ID: O20040401000328 |
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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. Jalisa White 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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Jalisa White, NNP
612 S 6th St,
Edwardsville, KS 66111-1393
Ph: (913) 309-9281 | Jalisa White, NNP
612 S 6th St,
Edwardsville, KS 66111-1393
Ph: (913) 309-9281 |
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