Evan Patrick Bickerstaff, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Kokomo, Indiana. His current practice location is
1907 W Sycamore St, Kokomo, Indiana. You can reach out to his office (for appointments etc.) via phone at
(765) 452-5611.
Evan Patrick Bickerstaff is licensed to practice in Indiana (license number 28254369A) 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 1790588150.
Provider's Profile
| Full Name | Evan Patrick Bickerstaff |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1907 W Sycamore St, Kokomo, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1790588150
- Provider Enumeration Date: 03/31/2025
- Last Update Date: 05/28/2025
Medicare PECOS Information:
- PECOS PAC ID: 0941719181
- Enrollment ID: I20250530001785
Medical Identifiers
Medical identifiers for Evan Patrick Bickerstaff such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1790588150 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 367500000X | Nurse Anesthetist, Certified Registered | 28254369A (Indiana) | Primary |
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. Evan Patrick Bickerstaff 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 |
Evan Patrick Bickerstaff, 5816 Beacon Cove Way, Indianapolis, IN 46237-9192 Ph: (270) 933-2552 | Evan Patrick Bickerstaff, 1907 W Sycamore St, Kokomo, IN 46901-5148 Ph: (765) 452-5611 |
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