Derek S Poulson, CRNA - Medicare Nurse Anesthetist, Certified Registered in Goshen, IN

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Derek S Poulson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Goshen, Indiana. His current practice location is 57809 Hillside Dr, Goshen, Indiana. You can reach out to his office (for appointments etc.) via phone at (801) 623-7813.

Derek S Poulson is licensed to practice in Maine (license number AA103025) 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 1033412440.

Contact Information

Derek S Poulson, CRNA
57809 Hillside Dr,
Goshen, IN 46528-4402
(801) 623-7813
Not Available

Map and Direction




Provider's Profile

Full NameDerek S Poulson
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location57809 Hillside Dr, Goshen, Indiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1033412440
  • Provider Enumeration Date: 12/08/2010
  • Last Update Date: 11/18/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 0345421566
  • Enrollment ID: I20170828001997

Medical Identifiers

Medical identifiers for Derek S Poulson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033412440NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered AA103025 (Maine)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. Derek S Poulson allows following entities to bill medicare on his behalf.
Entity NameGreater Anesthesia Solutions
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1124430244
PECOS PAC ID: 9234357906
Enrollment ID: O20140822000525
Entity NameNorth Gate Anesthesia Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073026464
PECOS PAC ID: 5294093654
Enrollment ID: O20171213001910

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. Derek S Poulson 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
Derek S Poulson, CRNA
57809 Hillside Dr,
Goshen, IN 46528-4402

Ph: (801) 623-7813		Derek S Poulson, CRNA
57809 Hillside Dr,
Goshen, IN 46528-4402

Ph: (801) 623-7813

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Goshen, IN

Janice Moore, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 200 High Park Ave, Goshen, IN 46526
Phone: 317-340-8384    
Brett Dyer, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 20208 Deer Path Ct., Goshen, IN 46528
Phone: 801-864-0218    

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.