Mr Evan M Chalfin, FNP is a medicare enrolled "Nurse Practitioner - Family" in Ferndale, California. His current practice location is
638 Main Street, Ferndale, California. You can reach out to his office (for appointments etc.) via phone at
(707) 786-4028.
Mr Evan M Chalfin is licensed to practice in California (license number 95008874) 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 1316485006.
Provider's Profile
| Full Name | Mr Evan M Chalfin |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 638 Main Street, Ferndale, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1316485006
- Provider Enumeration Date: 02/02/2017
- Last Update Date: 07/20/2018
Medicare PECOS Information:
- PECOS PAC ID: 6507136165
- Enrollment ID: I20180829004069
Medical Identifiers
Medical identifiers for Mr Evan M Chalfin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1316485006 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 201702103NP-PP (Oregon) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 341369 (New York) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 95008874 (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 Evan M Chalfin allows following entities to bill medicare on his behalf.
| Entity Name | Open Door Community Health Centers |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1497840656
PECOS PAC ID: 9436067485
Enrollment ID: O20040414000890 |
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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 Evan M Chalfin 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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Mr Evan M Chalfin, FNP
670 9th St Ste 203,
Arcata, CA 95521-6249
Ph: (707) 826-8633 | Mr Evan M Chalfin, FNP
638 Main Street,
Ferndale, CA 95536-1157
Ph: (707) 786-4028 |
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