Dr Chardonnay Vance, MD PHD is a medicare enrolled "Obstetrics & Gynecology - Obstetrics" physician in White Salmon, Washington. Her current practice location is
181 W Jewett Blvd, White Salmon, Washington. You can reach out to her office (for appointments etc.) via phone at
(509) 289-2119.
Dr Chardonnay Vance is licensed to practice in Oregon (license number MD181361) 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 1164834347.
Physician's Profile
| Full Name | Dr Chardonnay Vance |
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| Gender | Female |
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| Speciality | Obstetrics & Gynecology - Obstetrics |
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| Location | 181 W Jewett Blvd, White Salmon, Washington |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1164834347
- Provider Enumeration Date: 05/22/2014
- Last Update Date: 03/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 9638490642
- Enrollment ID: I20170116000486
Medical Identifiers
Medical identifiers for Dr Chardonnay Vance such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164834347 | NPI | - | NPPES |
| 2080300 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | MED-PHYS-LIC-53568 (Montana) | Secondary |
| 207Q00000X | Family Medicine | MD181361 (Oregon) | Secondary |
| 207Q00000X | Family Medicine | MD60734244 (Washington) | Secondary |
| 207Q00000X | Family Medicine | C1-0024847 (Delaware) | Secondary |
| 207Q00000X | Family Medicine | T6799 (Texas) | Secondary |
| 207Q00000X | Family Medicine | EMC0000406 (Michigan) | Secondary |
| 207Q00000X | Family Medicine | MC-0516 (Idaho) | Secondary |
| 207Q00000X | Family Medicine | 29232 (Mississippi) | Secondary |
| 207Q00000X | Family Medicine | 21735 (New Hampshire) | Secondary |
| 207Q00000X | Family Medicine | 21239 (Nevada) | Secondary |
| 207Q00000X | Family Medicine | 88601 (South Carolina) | Secondary |
| 207Q00000X | Family Medicine | 30684 (West Virginia) | Secondary |
| 207Q00000X | Family Medicine | 11037A (Wyoming) | Secondary |
| 207Q00000X | Family Medicine | 38523 (Oklahoma) | Secondary |
| 207VX0000X | Obstetrics & Gynecology - Obstetrics | MD181361 (Oregon) | 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. Dr Chardonnay Vance allows following entities to bill medicare on her behalf.
| Entity Name | Glutality Provider Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083256168
PECOS PAC ID: 9032549837
Enrollment ID: O20200827001943 |
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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. Dr Chardonnay Vance 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 |
|---|
Dr Chardonnay Vance, MD PHD
Po Box 2290,
White Salmon, WA 98672-2290
Ph: (314) 720-1644 | Dr Chardonnay Vance, MD PHD
181 W Jewett Blvd,
White Salmon, WA 98672-8974
Ph: (509) 289-2119 |
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