Mr Charles Joseph Paradise, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Medford, Oregon. His current practice location is
1333 E Barnett Rd, Medford, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 779-4711.
Mr Charles Joseph Paradise is licensed to practice in Oregon (license number 202002199CRNA) 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 1063402634.
Provider's Profile
| Full Name | Mr Charles Joseph Paradise |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1333 E Barnett Rd, Medford, Oregon |
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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: 1063402634
- Provider Enumeration Date: 10/25/2005
- Last Update Date: 07/31/2020
Medicare PECOS Information:
- PECOS PAC ID: 6507755139
- Enrollment ID: I20200608002289
Medical Identifiers
Medical identifiers for Mr Charles Joseph Paradise such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1063402634 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 367500000X | Nurse Anesthetist, Certified Registered | 691160 (Texas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 202002199CRNA (Oregon) | 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 Charles Joseph Paradise allows following entities to bill medicare on his behalf.
| Entity Name | Third Coast Anesthesia |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730812967 PECOS PAC ID: 1254709082 Enrollment ID: O20221217000134 |
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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. Mr Charles Joseph Paradise 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 |
Mr Charles Joseph Paradise, CRNA 1333 E Barnett Rd, Medford, OR 97504-8219 Ph: (361) 883-6211 | Mr Charles Joseph Paradise, CRNA 1333 E Barnett Rd, Medford, OR 97504-8219 Ph: (541) 779-4711 |
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