Dr Booker Theodore Evans, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Fair Banks, Alaska. His current practice location is
225 Wendell St, Suite B, Fair Banks, Alaska. You can reach out to his office (for appointments etc.) via phone at
(907) 455-4140.
Dr Booker Theodore Evans is licensed to practice in Arizona (license number AK4433) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1093756736.
Physician's Profile
| Full Name | Dr Booker Theodore Evans |
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| Gender | Male |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 225 Wendell St, Fair Banks, Alaska |
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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: 1093756736
- Provider Enumeration Date: 06/10/2006
- Last Update Date: 01/14/2008
Medicare PECOS Information:
- PECOS PAC ID: 2769495050
- Enrollment ID: I20091118000258
Medical Identifiers
Medical identifiers for Dr Booker Theodore Evans such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1093756736 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | AK4433 (Arizona) | 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 Booker Theodore Evans allows following entities to bill medicare on his behalf.
| Entity Name | Psj Acquisition Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1679709802
PECOS PAC ID: 7012062235
Enrollment ID: O20090918000240 |
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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 Booker Theodore Evans 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 Booker Theodore Evans, MD
225 Wendell St, Suite B,
Fair Banks, AK 99701
Ph: (907) 455-4140 | Dr Booker Theodore Evans, MD
225 Wendell St, Suite B,
Fair Banks, AK 99701
Ph: (907) 455-4140 |
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