Ms Jessica Lynn Matis, DNP, APRN, ACNP-AG is a medicare enrolled "Nurse Practitioner - Acute Care" in Baileys Crossroads, Virginia. Her current practice location is
Goodwin House, 3440 S. Jefferson Street, Baileys Crossroads, Virginia. You can reach out to her office (for appointments etc.) via phone at
(703) 820-1488.
Ms Jessica Lynn Matis is licensed to practice in Kentucky (license number 3010039) 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 1093164402.
Provider's Profile
| Full Name | Ms Jessica Lynn Matis |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Acute Care |
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| Location | Goodwin House, Baileys Crossroads, Virginia |
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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: 1093164402
- Provider Enumeration Date: 06/07/2016
- Last Update Date: 08/15/2019
Medicare PECOS Information:
- PECOS PAC ID: 5496049165
- Enrollment ID: I20160803003159
Medical Identifiers
Medical identifiers for Ms Jessica Lynn Matis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093164402 | NPI | - | NPPES |
| 201391850 | Medicaid | IN | |
| 50112260 | Other | KY | PASSPORT - NNIKY |
| 0000001021475 | Other | KY | ANTHEM - NNIKY |
| 215034 | Other | LA | SIHO - NNIKY |
| 7100415610 | Medicaid | KY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LG0600X | Nurse Practitioner - Gerontology | 3010039 (Kentucky) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 3010039 (Kentucky) | 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. Ms Jessica Lynn Matis allows following entities to bill medicare on her behalf.
| Entity Name | Community Medical Associates Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588614994
PECOS PAC ID: 7012811284
Enrollment ID: O20031120000656 |
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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. Ms Jessica Lynn Matis 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 |
|---|
Ms Jessica Lynn Matis, DNP, APRN, ACNP-AG
2101 Mill Rd Apt 113,
Alexandria, VA 22314-5318
Ph: (573) 450-1334 | Ms Jessica Lynn Matis, DNP, APRN, ACNP-AG
Goodwin House, 3440 S. Jefferson Street,
Baileys Crossroads, VA 22041-2204
Ph: (703) 820-1488 |
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