Mr Elliott Louis Koivisto, NP in Tigard, OR - Medicare Nurse Practitioner

Mr Elliott Louis Koivisto, NP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Tigard, Oregon. His current practice location is 7145 Sw Varns St Ste 206, Tigard, Oregon. You can reach out to his office (for appointments etc.) via phone at (971) 405-2584.

Mr Elliott Louis Koivisto is licensed to practice in Oregon (license number 10005745) 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 1407592397.

Contact Information

	Mr Elliott Louis Koivisto, NP
	7145 Sw Varns St Ste 206, Tigard, OR 97223-8168
	(971) 405-2584
	(800) 785-4531

Map and Direction

Provider's Profile

Full Name	Mr Elliott Louis Koivisto
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	7145 Sw Varns St Ste 206, Tigard, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1407592397
Provider Enumeration Date: 05/12/2022
Last Update Date: 11/17/2023

Medicare PECOS Information:

PECOS PAC ID: 5597121665
Enrollment ID: I20230515003183

Medical Identifiers

Medical identifiers for Mr Elliott Louis Koivisto such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1407592397	NPI	-	NPPES
201390875RN	Other	OR	OREGON STATE NURSING LICENSE NUMBER
RN60545376	Other	WA	WASHINGTON STATE DEPARTMENT OF HEALTH
AP61377025	Other	WA	WASHINGTON STATE DEPARTMENT OF HEALTH
10005745	Other	OR	OREGON STATE NURSING LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	AP61377025 (Washington)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	10005745 (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 Elliott Louis Koivisto allows following entities to bill medicare on his behalf.

Entity Name	Mindful Therapy Group, P.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1316238678 PECOS PAC ID: 4981872561 Enrollment ID: O20210301001586

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 Elliott Louis Koivisto 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 Elliott Louis Koivisto, NP 11785 Sw Robbins Dr, Beaverton, OR 97008-7949 Ph: (503) 522-2831	Mr Elliott Louis Koivisto, NP 7145 Sw Varns St Ste 206, Tigard, OR 97223-8168 Ph: (971) 405-2584

Reviews and Comments

Nurse Practitioner Nurses in Tigard, OR

Joseph Roy Zelk, DNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 10220 Sw Greenburg Rd., Suite 150, Tigard, OR 97223 Phone: 503-255-1200 Fax: 503-408-6856
Kecia Harris, ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 11481 Sw Hall Blvd Ste 200, Tigard, OR 97223 Phone: 503-980-4334
Mrs. Luiza Maria Brown, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7632 Sw Durham Rd Ste 130, Tigard, OR 97224 Phone: 800-936-4756
Martina D Ford, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 9370 Sw Greenburg Rd Ste 200, Tigard, OR 97223 Phone: 877-448-3627
Dr. Gretchen Randolph, PH.D, PMHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 13635 Sw 115th Ave, Tigard, OR 97223 Phone: 503-968-1155
Martha Patrice Geisheker, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 12442 Sw Scholls Ferry Rd Ste 100, Tigard, OR 97223 Phone: 503-216-9200
Alexandria Raene Thacker, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 12115 Sw 70th Ave Ste 202, Tigard, OR 97223 Phone: 503-404-2338

Mr Elliott Louis Koivisto, NP - Medicare Nurse Practitioner in Tigard, OR