Nicole Andrea Bennett, PMHNP-BC is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in East Alton, Illinois. She graduated from nursing school in 2024 and has 1 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Southern Illinois Healthcare Foundation, Inc. and her current practice location is
2 Terminal Dr Ste 8, East Alton, Illinois. You can reach out to her office (for appointments etc.) via phone at
(618) 259-0365.
Nicole Andrea Bennett is licensed to practice in Illinois (license number 209030085) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1679163372.
Provider's Profile
| Full Name | Nicole Andrea Bennett |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 1 Years |
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| Location | 2 Terminal Dr Ste 8, East Alton, Illinois |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nicole Andrea Bennett graduated from nursing school in 2024
NPI Data:
- NPI Number: 1679163372
- Provider Enumeration Date: 01/26/2021
- Last Update Date: 08/07/2024
Medicare PECOS Information:
- PECOS PAC ID: 6406397710
- Enrollment ID: I20240926000042
Medical Identifiers
Medical identifiers for Nicole Andrea Bennett such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1679163372 | NPI | - | NPPES |
| 041470020 | Other | IL | RN |
| 2018036588 | Other | MO | RN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163WP0808X | Registered Nurse - Psychiatric/mental Health | 2018036588 (Missouri) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 209030085 (Illinois) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Southern Illinois Healthcare Foundation, Inc. | 1456256874 | 115 |
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. Nicole Andrea Bennett allows following entities to bill medicare on her behalf.
| Entity Name | Southern Illinois Healthcare Foundation, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609813500
PECOS PAC ID: 1456256874
Enrollment ID: O20031126000641 |
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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. Nicole Andrea Bennett 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 |
|---|
Nicole Andrea Bennett, PMHNP-BC
2 Terminal Dr Ste 8,
East Alton, IL 62024-2294
Ph: (618) 259-0365 | Nicole Andrea Bennett, PMHNP-BC
2 Terminal Dr Ste 8,
East Alton, IL 62024-2294
Ph: (618) 259-0365 |
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