Mr Blaine Christopher Van Ausdeln, FNP-C, MS - Medicare Nurse Practitioner in Stockton, CA

Mr Blaine Christopher Van Ausdeln, FNP-C, MS is a medicare enrolled "Nurse Practitioner - Family" in Stockton, California. His current practice location is 7373 West Ln, Stockton, California. You can reach out to his office (for appointments etc.) via phone at (209) 476-3569.

Mr Blaine Christopher Van Ausdeln is licensed to practice in California (license number 326768/4523) 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 1194720144.

Contact Information

Mr Blaine Christopher Van Ausdeln, FNP-C, MS
7373 West Ln,
Stockton, CA 95210-3377
(209) 476-3569
(209) 476-3675

Map and Direction




Provider's Profile

Full NameMr Blaine Christopher Van Ausdeln
GenderMale
SpecialityNurse Practitioner - Family
Location7373 West Ln, Stockton, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1194720144
  • Provider Enumeration Date: 06/16/2005
  • Last Update Date: 07/09/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 6305872987
  • Enrollment ID: I20050714000747

Medical Identifiers

Medical identifiers for Mr Blaine Christopher Van Ausdeln such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1194720144NPI-NPPES
RN326768OtherCAMEDICAL PROVIDER ID

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 326768/4523 (California)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. Mr Blaine Christopher Van Ausdeln allows following entities to bill medicare on his behalf.
Entity NamePermanente Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710

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. Mr Blaine Christopher Van Ausdeln 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
Mr Blaine Christopher Van Ausdeln, FNP-C, MS
7373 West Ln,
Stockton, CA 95210-3377

Ph: (209) 476-3569
Mr Blaine Christopher Van Ausdeln, FNP-C, MS
7373 West Ln,
Stockton, CA 95210-3377

Ph: (209) 476-3569

Reviews and Comments


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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.