Jennifer Lyn Stickelmeyer, is a medicare enrolled "Nurse Practitioner - Family" in Porter, Oklahoma. Her current practice location is
505 S Main St, Porter, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 483-0111.
Jennifer Lyn Stickelmeyer is licensed to practice in Oklahoma (license number R0069196) 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 1548730559.
Provider's Profile
| Full Name | Jennifer Lyn Stickelmeyer |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 505 S Main St, Porter, Oklahoma |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1548730559
- Provider Enumeration Date: 12/03/2018
- Last Update Date: 02/13/2019
Medicare PECOS Information:
- PECOS PAC ID: 1052650389
- Enrollment ID: I20190305001266
Medical Identifiers
Medical identifiers for Jennifer Lyn Stickelmeyer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1548730559 | NPI | - | NPPES |
| H081616683 | Other | OK | DRIVERS LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | R0069196 (Oklahoma) | 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. Jennifer Lyn Stickelmeyer allows following entities to bill medicare on her behalf.
| Entity Name | Arkansas Verdigris Valley Health Centers, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083740047 PECOS PAC ID: 2961594916 Enrollment ID: O20070822000520 |
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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. Jennifer Lyn Stickelmeyer 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 |
Jennifer Lyn Stickelmeyer, 22272 E 730 Rd, Wagoner, OK 74467-6837 Ph: (918) 694-9766 | Jennifer Lyn Stickelmeyer, 505 S Main St, Porter, OK 74454-1015 Ph: (918) 483-0111 |
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