MANFREDO FLORESCRUZ
NPI 1407673908
Psychologist in Fulton, MO

Active since September 25, 2024PECOS Enrolled
600 EAST FIFITH STREET, FULTON, MO 65251(573) 592-2030 Get Directions Write a Review

NPPES record last updated: September 25, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Manfredo Florescruz NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MANFREDO FLORESCRUZ (NPI 1407673908) is an individual psychologist in Fulton, Missouri, licensed in Missouri (2023049778) and active in the NPI registry since September 2024. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407673908
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameMANFREDO FLORESCRUZ
Location Address600 EAST FIFITH STREETFulton, MO 65251
Mailing Address600 East Fifith StreetFulton, MO 65251 · (573) 592-2030
Sole ProprietorNo
Enumeration DateSeptember 25, 2024
NPPES CertifiedSeptember 20, 2024
✔ NPI 1407673908 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License✔ Licensed in MO · 2023049778
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
600 EAST FIFITH STREET, Fulton, MO 65251

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Manfredo Florescruz is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Manfredo Florescruz reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Psychiatry
600 E 5TH ST
Fulton, MO 65251
  • Reassigned Medicare billing, Missouri enrollment
  • 39 clinicians in this Medicare group

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Manfredo Florescruz's NPI number?

The NPI number for Manfredo Florescruz is 1407673908. It was assigned to this individual provider in the NPPES registry on September 25, 2024.

Where is Manfredo Florescruz located?

Manfredo Florescruz practices at 600 East Fifith Street, Fulton, MO 65251. The listed phone number is (573) 592-2030.

What is Manfredo Florescruz's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Manfredo Florescruz enrolled in Medicare?

Yes. Manfredo Florescruz is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Manfredo Florescruz's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Manfredo Florescruz reassigns Medicare benefits to State Of Missouri (Fulton, MO). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Manfredo Florescruz's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Manfredo Florescruz was last updated on September 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.