Micaela T Theisen, DNP, FNP-BC - Medicare Nurse Practitioner in Chinle, AZ

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Micaela T Theisen, DNP, FNP-BC is a medicare enrolled "Nurse Practitioner - Family" physician in Chinle, Arizona. She went to University Of Washington School Of Medicine and graduated in 2013 and has 12 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice South Sound Inpatient Physicians Pllc, Grant County Public Hospital District 1 and her current practice location is Hwy 191 And Hospital Drive, Chinle, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 674-7090.

Micaela T Theisen is licensed to practice in Washington (license number AP60577678) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1902158421.

Contact Information

Micaela T Theisen, DNP, FNP-BC
Hwy 191 And Hospital Drive,
Chinle, AZ 86503
(928) 674-7090
Not Available

Map and Direction




Physician's Profile

Full NameMicaela T Theisen
GenderFemale
SpecialityNurse Practitioner
Experience12 Years
LocationHwy 191 And Hospital Drive, Chinle, Arizona
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Micaela T Theisen attended and graduated from University Of Washington School Of Medicine in 2013
  NPI Data:
  • NPI Number: 1902158421
  • Provider Enumeration Date: 10/08/2012
  • Last Update Date: 05/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 9830342369
  • Enrollment ID: I20150820010016

Medical Identifiers

Medical identifiers for Micaela T Theisen such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1902158421NPI-NPPES
2047222MedicaidWA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine AP60577678 (Washington)Secondary
363L00000XNurse Practitioner NP-1523A (Idaho)Secondary
363L00000XNurse Practitioner AP60577678 (Washington)Secondary
363LF0000XNurse Practitioner - Family AP60577678 (Washington)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Whidbeyhealth Medical CenterCoupeville, WAHospital
Samaritan HospitalMoses lake, WAHospital
Peacehealth United General Medical CenterSedro woolley, WAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
South Sound Inpatient Physicians Pllc5991618738381
Grant County Public Hospital District 1993109569281

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. Micaela T Theisen allows following entities to bill medicare on her behalf.
Entity NameSouth Sound Inpatient Physicians Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023285756
PECOS PAC ID: 5991618738
Enrollment ID: O20031107000668
Entity NameCogent Healthcare Of Washington, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861430522
PECOS PAC ID: 2062306350
Enrollment ID: O20040209000839
Entity NameWhidbey Island Public Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1710927231
PECOS PAC ID: 1658280680
Enrollment ID: O20040210000761
Entity NameGrant County Public Hospital District 1
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1619086766
PECOS PAC ID: 9931095692
Enrollment ID: O20040227000602
Entity NameWhidbey Island Public Hospital District
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1710927231
PECOS PAC ID: 1658280680
Enrollment ID: O20071105000513
Entity NamePeacehealth
Entity TypePart A Provider - Critical Access Hospital
Entity IdentifiersNPI Number: 1144664954
PECOS PAC ID: 6103056288
Enrollment ID: O20140312000236
Entity NamePeacehealth
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548698806
PECOS PAC ID: 6103056288
Enrollment ID: O20140507000955
Entity NameSound Physicians Emergency Medicine Of Washington Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1629532064
PECOS PAC ID: 7315279007
Enrollment ID: O20191030000855
Entity NameHospitalist Medicine Physicians Of California-san Bernardino, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1376188078
PECOS PAC ID: 4082041280
Enrollment ID: O20200228000868

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. Micaela T Theisen 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 AddressPractice Location Address
Micaela T Theisen, DNP, FNP-BC
945 E 42nd Ave,
Spokane, WA 99203-6201

Ph: (509) 202-8109		Micaela T Theisen, DNP, FNP-BC
Hwy 191 And Hospital Drive,
Chinle, AZ 86503

Ph: (928) 674-7090

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.