Simon Muttanil Chacko Jr, ARNP - Medicare Nurse Practitioner in Tampa, FL

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Simon Muttanil Chacko Jr, ARNP is a medicare enrolled "Nurse Practitioner" in Tampa, Florida. His current practice location is 3117 W Gandy Blvd, Tampa, Florida. You can reach out to his office (for appointments etc.) via phone at (872) 231-3162.

Simon Muttanil Chacko Jr is licensed to practice in Florida (license number APRN9406548) 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 1477782860.

Contact Information

Simon Muttanil Chacko Jr, ARNP
3117 W Gandy Blvd,
Tampa, FL 33611-2927
(872) 231-3162
(702) 977-1496

Map and Direction




Provider's Profile

Full NameSimon Muttanil Chacko Jr
GenderMale
SpecialityNurse Practitioner
Location3117 W Gandy Blvd, Tampa, Florida
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1477782860
  • Provider Enumeration Date: 07/07/2009
  • Last Update Date: 10/03/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 8325322753
  • Enrollment ID: I20170303000864

Medical Identifiers

Medical identifiers for Simon Muttanil Chacko Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1477782860NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363L00000XNurse Practitioner APRN9406548 (Florida)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. Simon Muttanil Chacko Jr allows following entities to bill medicare on his behalf.
Entity NameBrandon-riverview Medical
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235411000
PECOS PAC ID: 1456518430
Enrollment ID: O20120202000230
Entity NameDedicated Senior Medical Center Of Florida, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881055366
PECOS PAC ID: 4486932100
Enrollment ID: O20161101001703
Entity NameIntegrated Rehab Consultants Florida Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1245700244
PECOS PAC ID: 4486997426
Enrollment ID: O20190515001526
Entity NameLuxehealth Florida Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1487263166
PECOS PAC ID: 2466865001
Enrollment ID: O20201229000148

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. Simon Muttanil Chacko Jr 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 AddressPractice Location Address
Simon Muttanil Chacko Jr, ARNP
Po Box 7410884,
Chicago, IL 60674-0884

Ph: (702) 899-0595		Simon Muttanil Chacko Jr, ARNP
3117 W Gandy Blvd,
Tampa, FL 33611-2927

Ph: (872) 231-3162

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.