Dr Nicholas James Evertsen, DO is a medicare enrolled "Plastic Surgery" physician in Sayre, Pennsylvania. His current practice location is
1 Guthrie Sq, Sayre, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(570) 887-2855.
Dr Nicholas James Evertsen is licensed to practice in Pennsylvania (license number OS013911) 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 1881846897.
Physician's Profile
| Full Name | Dr Nicholas James Evertsen |
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| Gender | Male |
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| Speciality | Plastic Surgery |
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| Location | 1 Guthrie Sq, Sayre, Pennsylvania |
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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: 1881846897
- Provider Enumeration Date: 10/21/2008
- Last Update Date: 04/07/2021
Medicare PECOS Information:
- PECOS PAC ID: 1153516109
- Enrollment ID: I20101116000644
Medical Identifiers
Medical identifiers for Dr Nicholas James Evertsen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881846897 | NPI | - | NPPES |
| 03248437 | Medicaid | NY | |
| 102500574 | Medicaid | PA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208200000X | Plastic Surgery | OS013911 (Pennsylvania) | 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 Nicholas James Evertsen allows following entities to bill medicare on his behalf.
| Entity Name | Guthrie Medical Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1962451153
PECOS PAC ID: 6002728656
Enrollment ID: O20040301000571 |
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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 Nicholas James Evertsen 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 Nicholas James Evertsen, DO
1 Guthrie Sq,
Sayre, PA 18840-1625
Ph: (570) 888-5858 | Dr Nicholas James Evertsen, DO
1 Guthrie Sq,
Sayre, PA 18840-1625
Ph: (570) 887-2855 |
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