Stephanie Ann Fortman, PMHNP in Indianapolis, IN

Stephanie Ann Fortman, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Indianapolis, Indiana. Her current practice location is 1311 W 96th St, Indianapolis, Indiana. You can reach out to her office (for appointments etc.) via phone at (765) 698-8192.

Stephanie Ann Fortman is licensed to practice in Indiana (license number 71016070A) 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 1902643729.

Contact Information

	Stephanie Ann Fortman, PMHNP
	1311 W 96th St, Indianapolis, IN 46260-1191
	(765) 698-8192
	Not Available

Map and Direction

Provider's Profile

Full Name	Stephanie Ann Fortman
Gender	Female
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1311 W 96th St, Indianapolis, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1902643729
Provider Enumeration Date: 07/10/2024
Last Update Date: 11/25/2024

Medicare PECOS Information:

PECOS PAC ID: 6800316829
Enrollment ID: I20250220003523

Medical Identifiers

Medical identifiers for Stephanie Ann Fortman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902643729	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	28268154A (Indiana)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	71016070A (Indiana)	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. Stephanie Ann Fortman allows following entities to bill medicare on her behalf.

Entity Name	Mending Minds, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780258798 PECOS PAC ID: 4284037987 Enrollment ID: O20210719001995

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. Stephanie Ann Fortman 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
Stephanie Ann Fortman, PMHNP Po Box 304, Cambridge City, IN 47327-0304 Ph: (765) 698-8192	Stephanie Ann Fortman, PMHNP 1311 W 96th St, Indianapolis, IN 46260-1191 Ph: (765) 698-8192

Reviews and Comments

Nurse Practitioner Nurses in Indianapolis, IN

Ms. Monica Silvia Oclander, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: Action Health Center, 2868 N. Pennsylvania Street, Indianapolis, IN 46205 Phone: 317-221-3532 Fax: 317-221-3516
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Emily Kelly Koffel, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 8330 Naab Rd Ste 340, Indianapolis, IN 46260 Phone: 317-338-5100
Mrs. Kelly Lentz, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2732 W Michigan St, Indianapolis, IN 46222 Phone: 317-554-4600 Fax: 317-554-4617
Samantha Lee Stalnaker, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1919 E 52nd St, Indianapolis, IN 46205 Phone: 317-429-0120 Fax: 317-800-7730

Stephanie Ann Fortman, PMHNP - Medicare Nurse Practitioner in Indianapolis, IN