Mr Roosevelt Hezekiah Wortham-florence, NP is a medicare enrolled "Nurse Practitioner - Family" in Union, Ohio. He graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. His current practice location is
113 Clarett Ct, Union, Ohio. You can reach out to his office (for appointments etc.) via phone at
(937) 321-0002.
Mr Roosevelt Hezekiah Wortham-florence is licensed to practice in Ohio (license number APRN.CNP.0029130) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1780132852.
Provider's Profile
| Full Name | Mr Roosevelt Hezekiah Wortham-florence |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 113 Clarett Ct, Union, Ohio |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mr Roosevelt Hezekiah Wortham-florence graduated from nursing school in 2021
NPI Data:
- NPI Number: 1780132852
- Provider Enumeration Date: 09/16/2016
- Last Update Date: 01/15/2026
Medicare PECOS Information:
- PECOS PAC ID: 5294120366
- Enrollment ID: I20250424000865
Medical Identifiers
Medical identifiers for Mr Roosevelt Hezekiah Wortham-florence such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1780132852 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | APRN.CNP.0029130 (Ohio) | 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 Roosevelt Hezekiah Wortham-florence allows following entities to bill medicare on his behalf.
| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20201214003096 |
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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. Mr Roosevelt Hezekiah Wortham-florence 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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Mr Roosevelt Hezekiah Wortham-florence, NP
113 Clarett Ct,
Union, OH 45322-3545
Ph: (937) 321-0002 | Mr Roosevelt Hezekiah Wortham-florence, NP
113 Clarett Ct,
Union, OH 45322-3545
Ph: (937) 321-0002 |
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