Andrea L Nutt, FNP is a medicare enrolled "Nurse Practitioner - Family" in Sheridan, Oregon. She graduated from nursing school in 2017 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Icco Llc and her current practice location is
222 Se Jefferson St, Sheridan, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 843-1535.
Andrea L Nutt is licensed to practice in Oregon (license number 201705780NP-PP) 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 1093192965.
Provider's Profile
| Full Name | Andrea L Nutt |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 9 Years |
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| Location | 222 Se Jefferson St, Sheridan, Oregon |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Andrea L Nutt graduated from nursing school in 2017
NPI Data:
- NPI Number: 1093192965
- Provider Enumeration Date: 04/29/2015
- Last Update Date: 08/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 0547533325
- Enrollment ID: I20170829004196
Medical Identifiers
Medical identifiers for Andrea L Nutt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1093192965 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 201705780NP-PP (Oregon) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Icco Llc | 1355406729 | 108 |
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. Andrea L Nutt allows following entities to bill medicare on her behalf.
| Entity Name | Northwest Medical Foundation Of Tillamook |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871575225
PECOS PAC ID: 5092619569
Enrollment ID: O20031208000676 |
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| Entity Name | Icco Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1407004757
PECOS PAC ID: 1355406729
Enrollment ID: O20090218000510 |
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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. Andrea L Nutt 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 |
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Andrea L Nutt, FNP
Po Box 1023,
Roseburg, OR 97470-0232
Ph: (541) 440-6390 | Andrea L Nutt, FNP
222 Se Jefferson St,
Sheridan, OR 97378-1924
Ph: (503) 843-1535 |
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