Stephanie Breault, in Forsyth, MO - Medicare Nurse Practitioner

Stephanie Breault, is a medicare enrolled "Nurse Practitioner - Family" in Forsyth, Missouri. Her current practice location is 256 State Highway Y, Forsyth, Missouri. You can reach out to her office (for appointments etc.) via phone at (417) 546-4200.

Stephanie Breault is licensed to practice in Missouri (license number 2021011336) 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 1619556016.

Contact Information

	Stephanie Breault,
	256 State Highway Y, Forsyth, MO 65653-5618
	(417) 546-4200
	(417) 546-4505

Map and Direction

Provider's Profile

Full Name	Stephanie Breault
Gender	Female
Speciality	Nurse Practitioner - Family
Location	256 State Highway Y, Forsyth, Missouri
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619556016
Provider Enumeration Date: 04/05/2021
Last Update Date: 04/05/2021

Medicare PECOS Information:

PECOS PAC ID: 7012306822
Enrollment ID: I20241029003897

Medical Identifiers

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

Identifier	Type	State	Issuer
1619556016	NPI	-	NPPES
2021011336	Other	MO	LICENSE NUMBER

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	2021011336 (Missouri)	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 Breault allows following entities to bill medicare on her behalf.

Entity Name	Citizens Memorial Healthcare
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568566131 PECOS PAC ID: 4183528169 Enrollment ID: O20040315001374

Entity Name	Mercy Southern Missouri Ambulatory Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871094052 PECOS PAC ID: 5193089621 Enrollment ID: O20180508002317

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 Breault 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 Breault, Po Box 1240, Forsyth, MO 65653-1240 Ph: (417) 546-4200	Stephanie Breault, 256 State Highway Y, Forsyth, MO 65653-5618 Ph: (417) 546-4200

Reviews and Comments

Nurse Practitioner Nurses in Forsyth, MO

Kayla M Jenkins, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 256 State Highway Y, Forsyth, MO 65653 Phone: 417-546-4200 Fax: 417-546-4505
Michele Depalma, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 256 State Highway Y, Forsyth, MO 65653 Phone: 417-546-4200 Fax: 417-546-4505
Sheila Louise Wyman, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10726 State Highway 76, Ste G, Forsyth, MO 65653 Phone: 417-546-2590 Fax: 417-546-2594
Jordyn R Custer, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 256 State Highway Y, Forsyth, MO 65653 Phone: 417-546-4200
Mrs. Linda J Mckinney, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 256 State Highway Y, Forsyth, MO 65653 Phone: 417-546-4200 Fax: 417-546-4505
Mrs. Stephanie Marie Wood, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 13852 Us Highway 160, Forsyth, MO 65653 Phone: 417-546-4500 Fax: 417-546-3343
Leah Grubbs, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 256 State Highway Y, Forsyth, MO 65653 Phone: 417-546-4200

Stephanie Breault, - Medicare Nurse Practitioner in Forsyth, MO