Alicia R Wyatt, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Saint Francis, Kansas. Her current practice location is
210 W 1st St, Saint Francis, Kansas. You can reach out to her office (for appointments etc.) via phone at
(785) 332-2104.
Alicia R Wyatt is licensed to practice in Kansas (license number 43-557204) 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 1417382649.
Provider's Profile
| Full Name | Alicia R Wyatt |
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| Gender | Female |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 210 W 1st St, Saint Francis, Kansas |
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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: 1417382649
- Provider Enumeration Date: 09/06/2013
- Last Update Date: 05/09/2025
Medicare PECOS Information:
- PECOS PAC ID: 6305073586
- Enrollment ID: I20131213001117
Medical Identifiers
Medical identifiers for Alicia R Wyatt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417382649 | NPI | - | NPPES |
| 30004530900001 | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 43-557204 (Kansas) | 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. Alicia R Wyatt allows following entities to bill medicare on her behalf.
| Entity Name | Kansas Spine Anesthesia Corporation Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720345911
PECOS PAC ID: 1153586821
Enrollment ID: O20120702000174 |
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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. Alicia R Wyatt 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 |
|---|
Alicia R Wyatt,
210 W 1st St,
Saint Francis, KS 67756-3540
Ph: (785) 332-2104 | Alicia R Wyatt,
210 W 1st St,
Saint Francis, KS 67756-3540
Ph: (785) 332-2104 |
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