Mr Charles Douglas Balcome, ACNP in Phoenix, AZ

Mr Charles Douglas Balcome, ACNP is a medicare enrolled "Nurse Practitioner - Acute Care" in Phoenix, Arizona. His current practice location is 16601 N 40th St Ste 204, Phoenix, Arizona. You can reach out to his office (for appointments etc.) via phone at (602) 633-3721.

Mr Charles Douglas Balcome is licensed to practice in Arizona (license number AP11604) 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 1376027557.

Contact Information

	Mr Charles Douglas Balcome, ACNP
	16601 N 40th St Ste 204, Phoenix, AZ 85032-3356
	(602) 633-3721
	(602) 595-1127

Map and Direction

Provider's Profile

Full Name	Mr Charles Douglas Balcome
Gender	Male
Speciality	Nurse Practitioner - Acute Care
Location	16601 N 40th St Ste 204, Phoenix, Arizona
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376027557
Provider Enumeration Date: 09/24/2018
Last Update Date: 10/20/2021

Medicare PECOS Information:

PECOS PAC ID: 8921342767
Enrollment ID: I20181204003698

Medical Identifiers

Medical identifiers for Mr Charles Douglas Balcome such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376027557	NPI	-	NPPES
443489	Medicaid	AZ

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LA2100X	Nurse Practitioner - Acute Care	AP11604 (Arizona)	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. Mr Charles Douglas Balcome allows following entities to bill medicare on his behalf.

Entity Name	Honorhealth
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1801092564 PECOS PAC ID: 1456258607 Enrollment ID: O20031216000350

Entity Name	Honorhealth Ambulatory
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1407050917 PECOS PAC ID: 5991603110 Enrollment ID: O20071005000449

Entity Name	Acute Care Surgical Specialists Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1225311871 PECOS PAC ID: 7315106416 Enrollment ID: O20120308000890

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. Mr Charles Douglas Balcome 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
Mr Charles Douglas Balcome, ACNP 22331 N 79th Dr, Peoria, AZ 85383-2157 Ph: (602) 335-9374	Mr Charles Douglas Balcome, ACNP 16601 N 40th St Ste 204, Phoenix, AZ 85032-3356 Ph: (602) 633-3721

Reviews and Comments

Nurse Practitioner Nurses in Phoenix, AZ

Ms. Karla D Wax, N.P.-C. Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1331 N 7th St, Suite 275, Phoenix, AZ 85006 Phone: 602-254-3151 Fax: 602-256-9581
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Tyler Ann Brockhoff, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1710 N 16th St Ste F1, Phoenix, AZ 85006 Phone: 623-224-3618 Fax: 623-244-1595
Rebecca Anne Shaw, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 16620 N 40th St Ste E1, Phoenix, AZ 85032 Phone: 602-464-9576 Fax: 480-428-0475
Susannamma Lijan, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 6850 W Indian School Rd, Phoenix, AZ 85033 Phone: 623-469-1331
Ms. Aldijana Bjelobrkovic, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4350 N 19th Ave Ste 3, Phoenix, AZ 85015 Phone: 602-279-4975 Fax: 602-279-1108

Mr Charles Douglas Balcome, ACNP - Medicare Nurse Practitioner in Phoenix, AZ