Michael D Nissen, NP-C is a medicare enrolled "Nurse Practitioner - Family" in Vernon, Florida. He graduated from nursing school in 2005 and has 20 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Pancare Of Florida, Inc and his current practice location is
3399 Ferris Cir, Vernon, Florida. You can reach out to his office (for appointments etc.) via phone at
(706) 594-6919.
Michael D Nissen is licensed to practice in Florida (license number 11026653) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1417077827.
Provider's Profile
| Full Name | Michael D Nissen |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Experience | 20 Years |
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| Location | 3399 Ferris Cir, Vernon, Florida |
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| Accepts Medicare Assignments | Yes. He 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:
- Michael D Nissen graduated from nursing school in 2005
NPI Data:
- NPI Number: 1417077827
- Provider Enumeration Date: 03/30/2007
- Last Update Date: 11/05/2024
Medicare PECOS Information:
- PECOS PAC ID: 9234307729
- Enrollment ID: I20241211001869
Medical Identifiers
Medical identifiers for Michael D Nissen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417077827 | NPI | - | NPPES |
| 7004922 | Medicaid | NC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | 242756 (North Carolina) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 11026653 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Pancare Of Florida, Inc | 3476574229 | 30 |
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. Michael D Nissen allows following entities to bill medicare on his behalf.
| Entity Name | Pancare Of Florida, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366456287
PECOS PAC ID: 3476574229
Enrollment ID: O20150116000294 |
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| Entity Name | Signify Health Medical Associates Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750845863
PECOS PAC ID: 2163764424
Enrollment ID: O20191209002247 |
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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. Michael D Nissen 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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Michael D Nissen, NP-C
3399 Ferris Cir,
Vernon, FL 32462-2217
Ph: (706) 594-6919 | Michael D Nissen, NP-C
3399 Ferris Cir,
Vernon, FL 32462-2217
Ph: (706) 594-6919 |
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