Larry Dean Mellott, CRNA in Ephrata, PA - Medicare Nurse Anesthetist, Certified Registered

Larry Dean Mellott, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Ephrata, Pennsylvania. His current practice location is 169 Martin Ave, Ephrata, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (717) 738-6618.

Larry Dean Mellott is licensed to practice in Pennsylvania (license number RN645912) 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 1053932749.

Contact Information

	Larry Dean Mellott, CRNA
	169 Martin Ave, Ephrata, PA 17522-1724
	(717) 738-6618
	(717) 738-6646

Map and Direction

Provider's Profile

Full Name	Larry Dean Mellott
Gender	Male
Speciality	Nurse Anesthetist, Certified Registered
Location	169 Martin Ave, Ephrata, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1053932749
Provider Enumeration Date: 05/04/2020
Last Update Date: 03/27/2025

Medicare PECOS Information:

PECOS PAC ID: 1052742681
Enrollment ID: I20200514000211

Medical Identifiers

Medical identifiers for Larry Dean Mellott such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1053932749	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	RN645912 (Pennsylvania)	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. Larry Dean Mellott allows following entities to bill medicare on his behalf.

Entity Name	Wellspan Medical Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669770004 PECOS PAC ID: 1951213115 Enrollment ID: O20040220000815

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. Larry Dean Mellott 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
Larry Dean Mellott, CRNA 601 Memory Ln, York, PA 17402-2231 Ph: (717) 851-1405	Larry Dean Mellott, CRNA 169 Martin Ave, Ephrata, PA 17522-1724 Ph: (717) 738-6618

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Ephrata, PA

Michele Deiterich, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 169 Martin Ave, Ephrata, PA 17522 Phone: 717-733-0311 Fax: 717-721-5861
Mr. Jason Michael Dulimba, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 169 Martin Ave, Ephrata, PA 17522 Phone: 717-733-0311
Brian Vells, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: Po Box 1002, Ephrata, PA 17522 Phone: 717-738-6618 Fax: 717-738-6646
Ms. Raquel Vanessa Wiker, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 169 Martin Ave, Ephrata, PA 17522 Phone: 717-733-0311
Steven C Vandevander, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 169 Martin Ave, Ephrata, PA 17522 Phone: 717-733-0311 Fax: 717-721-5861
Mrs. Kathleen Hill, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 169 Martin Ave, Ephrata, PA 17522 Phone: 717-733-0311

Larry Dean Mellott, CRNA - Medicare Nurse Anesthetist, Certified Registered in Ephrata, PA