Elizabeth Elaine Sundberg, MD PHD is a medicare enrolled "Internal Medicine - Nephrology" physician in Elgin, North Dakota. Her current practice location is
601 East St. N, Elgin, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 584-2792.
Elizabeth Elaine Sundberg is licensed to practice in North Dakota (license number 9008) 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 1407902919.
Physician's Profile
| Full Name | Elizabeth Elaine Sundberg |
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| Gender | Female |
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| Speciality | Internal Medicine - Nephrology |
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| Location | 601 East St. N, Elgin, North Dakota |
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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: 1407902919
- Provider Enumeration Date: 01/26/2007
- Last Update Date: 07/31/2019
Medicare PECOS Information:
- PECOS PAC ID: 7719965169
- Enrollment ID: I20050914001450
Medical Identifiers
Medical identifiers for Elizabeth Elaine Sundberg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407902919 | NPI | - | NPPES |
| 28837 | Other | WA | STATE LICENSE |
| 9008 | Other | ND | STATE LICENSE |
| 1457964 | Medicaid | ND | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 9008 (North Dakota) | Secondary |
| 207RN0300X | Internal Medicine - Nephrology | 9008 (North Dakota) | 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. Elizabeth Elaine Sundberg allows following entities to bill medicare on her behalf.
| Entity Name | Jacobson Memorial Hospital Care Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871691519
PECOS PAC ID: 2466363981
Enrollment ID: O20031210001025 |
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| Entity Name | Jacobson Memorial Hospital Care Center |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1336196039
PECOS PAC ID: 2466363981
Enrollment ID: O20070223000598 |
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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. Elizabeth Elaine Sundberg 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 |
|---|
Elizabeth Elaine Sundberg, MD PHD
601 East St. N,
Elgin, ND 58533
Ph: (701) 584-2792 | Elizabeth Elaine Sundberg, MD PHD
601 East St. N,
Elgin, ND 58533
Ph: (701) 584-2792 |
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