Misty Autumn Mcgillem, DNP in Tucson, AZ - Medicare Nurse Practitioner

Misty Autumn Mcgillem, DNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Tucson, Arizona. Her current practice location is 3939 S Park Ave, Tucson, Arizona. You can reach out to her office (for appointments etc.) via phone at (520) 333-4320.

Misty Autumn Mcgillem is licensed to practice in Arizona (license number AP9889) 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 1467847822.

Contact Information

	Misty Autumn Mcgillem, DNP
	3939 S Park Ave, Tucson, AZ 85714-1635
	(520) 333-4320
	Not Available

Map and Direction

Provider's Profile

Full Name	Misty Autumn Mcgillem
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	3939 S Park Ave, Tucson, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1467847822
Provider Enumeration Date: 04/02/2015
Last Update Date: 07/21/2022

Medicare PECOS Information:

PECOS PAC ID: 3870869654
Enrollment ID: I20171023001789

Medical Identifiers

Medical identifiers for Misty Autumn Mcgillem such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1467847822	NPI	-	NPPES
235041	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	AP9889 (Arizona)	Primary
163W00000X	Registered Nurse	RN 175929 (Arizona)	Secondary

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. Misty Autumn Mcgillem allows following entities to bill medicare on her behalf.

Entity Name	Summit Behavioral Health Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1497370258 PECOS PAC ID: 8729485313 Enrollment ID: O20220322001333

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. Misty Autumn Mcgillem 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
Misty Autumn Mcgillem, DNP 4575 E Broadway Blvd, Tucson, AZ 85711-3509 Ph: (520) 325-4268	Misty Autumn Mcgillem, DNP 3939 S Park Ave, Tucson, AZ 85714-1635 Ph: (520) 333-4320

Reviews and Comments

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Misty Autumn Mcgillem, DNP - Medicare Nurse Practitioner in Tucson, AZ