Robert L Ellison, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" physician in Moscow, Idaho. His current practice location is
2300 W A St, Moscow, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 883-1500.
Robert L Ellison is licensed to practice in Idaho (license number RNA-209) 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 1265425714.
Physician's Profile
| Full Name | Robert L Ellison |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 2300 W A St, Moscow, Idaho |
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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: 1265425714
- Provider Enumeration Date: 08/30/2005
- Last Update Date: 07/13/2010
Medicare PECOS Information:
- PECOS PAC ID: 5294712733
- Enrollment ID: I20040814000049
Medical Identifiers
Medical identifiers for Robert L Ellison such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1265425714 | NPI | - | NPPES |
| 9628264 | Medicaid | WA | |
| A3565 | Other | ID | BC ID |
| N13917 | Other | ID | IDAHO LICENSE |
| P00137189 | Other | | RAILROAD MEDICARE |
| 805788500 | Medicaid | ID | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | N13917 (Idaho) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | RNA-209 (Idaho) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | AP30004667 (Washington) | Secondary |
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. Robert L Ellison allows following entities to bill medicare on his behalf.
| Entity Name | Moscow Mountain Anesthesia Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275074486
PECOS PAC ID: 4082981881
Enrollment ID: O20170526001871 |
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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. Robert L Ellison 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 |
|---|
Robert L Ellison, CRNA
Po Box 1829,
Coeur D Alene, ID 83816-1829
Ph: (208) 667-9334 | Robert L Ellison, CRNA
2300 W A St,
Moscow, ID 83843-4038
Ph: (208) 883-1500 |
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