Jean Elizze Mabute Charles, DO - Medicare Dermatology in Fort Worth, TX

Jean Elizze Mabute Charles, DO is a medicare enrolled "Dermatology" physician in Fort Worth, Texas. She went to University Of North Texas Hsc, College Of Osteopathic Med and graduated in 2017 and has 7 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Oliver Street 5.01(a) Inc and her current practice location is 855 Montgomery St Fl 6, Fort Worth, Texas. You can reach out to her office (for appointments etc.) via phone at (817) 735-7625.

Jean Elizze Mabute Charles is licensed to practice in Texas (license number T1316) 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 1376075507.

Contact Information

Jean Elizze Mabute Charles, DO
855 Montgomery St Fl 6,
Fort Worth, TX 76107-2553
(817) 735-7625
Not Available



Physician's Profile

Full NameJean Elizze Mabute Charles
GenderFemale
SpecialityDermatology
Experience7 Years
Location855 Montgomery St Fl 6, Fort Worth, Texas
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Jean Elizze Mabute Charles attended and graduated from University Of North Texas Hsc, College Of Osteopathic Med in 2017
  NPI Data:
  • NPI Number: 1376075507
  • Provider Enumeration Date: 03/28/2017
  • Last Update Date: 07/09/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 9739458928
  • Enrollment ID: I20210714003021

Medical Identifiers

Medical identifiers for Jean Elizze Mabute Charles such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1376075507NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207N00000XDermatology T1316 (Texas)Primary
390200000XStudent In An Organized Health Care Education/training Program BP20065105 (Texas)Secondary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Oliver Street 5.01(a) Inc0042464125141

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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. Jean Elizze Mabute Charles allows following entities to bill medicare on her behalf.
Entity NameUniversity Of North Texas Health Science Center At Fort Worth
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376645564
PECOS PAC ID: 6103717350
Enrollment ID: O20040324001382

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Entity NameOliver Street 5.01(a) Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457695413
PECOS PAC ID: 0042464125
Enrollment ID: O20130128000189

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Entity NameConcierge Dermatology Management, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134615206
PECOS PAC ID: 8820341993
Enrollment ID: O20181019002091

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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. Jean Elizze Mabute Charles 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
Jean Elizze Mabute Charles, DO
855 Montgomery St, Fl 6,
Fort Worth, TX 76107-2553

Ph: (682) 582-2921
Jean Elizze Mabute Charles, DO
855 Montgomery St Fl 6,
Fort Worth, TX 76107-2553

Ph: (817) 735-7625

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Dermatology Doctors in Fort Worth, TX

Diego Esteban Marra, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 2801 S Hulen St Ste 400, Fort Worth, TX 76109
Phone: 817-921-2838    
Dr. Allison Beckworth Readinger, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 800 8th Ave Ste 326, Fort Worth, TX 76104
Phone: 817-885-8222    Fax: 817-885-8663
Kimberly J Parham, MD
Dermatology
Medicare: Not Enrolled in Medicare
Practice Location: 6600 Bryant Irvin Rd, Fort Worth, TX 76132
Phone: 817-820-0011    Fax: 817-820-0073
Molly Mae Warthan, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 5751 Edwards Ranch Rd Ste 101, Fort Worth, TX 76109
Phone: 817-923-8220    Fax: 817-923-9004
Dr. Stephen D Maberry, MD
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 1200 W Rosedale St, Fort Worth, TX 76104
Phone: 817-336-8131    
Dr. James Richmond Mccarty, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 4305 S Hulen St, Fort Worth, TX 76109
Phone: 817-920-9023    Fax: 817-923-6013
Bryan J Carroll, M.D.
Dermatology
Medicare: Accepting Medicare Assignments
Practice Location: 6900 Harris Pkwy Ste 200, Fort Worth, TX 76132
Phone: 817-292-3376    Fax: 844-886-8347

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