Mr Lynn A Peterson, MSN, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Newport, Washington. His current practice location is
714 W Pine St, Newport, Washington. You can reach out to his office (for appointments etc.) via phone at
(509) 447-2441.
Mr Lynn A Peterson is licensed to practice in Washington (license number AP30006221) 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 1720165160.
Provider's Profile
| Full Name | Mr Lynn A Peterson |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 714 W Pine St, Newport, Washington |
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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: 1720165160
- Provider Enumeration Date: 11/01/2006
- Last Update Date: 06/25/2019
Medicare PECOS Information:
- PECOS PAC ID: 1153381868
- Enrollment ID: I20041018000284
Medical Identifiers
Medical identifiers for Mr Lynn A Peterson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720165160 | NPI | - | NPPES |
| G000381050 | Other | WA | MEDICARE GROUP NUMBER |
| P00395894 | Other | WA | MEDICARE RAILROAD |
| CG4026 | Other | WA | RAILROAD GROUP NUMBER |
| 9636465 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP30006221 (Washington) | 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 Lynn A Peterson allows following entities to bill medicare on his behalf.
| Entity Name | Pend Oreille County Public Hospital District No 1 |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427264795
PECOS PAC ID: 3274431184
Enrollment ID: O20031230000017 |
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| Entity Name | Pend Oreille County Public Hospital District No 1 |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1780778423
PECOS PAC ID: 3274431184
Enrollment ID: O20061104000539 |
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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 Lynn A Peterson 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 Lynn A Peterson, MSN, CRNA
3412 S Jefferson Dr,
Spokane, WA 99203-1421
Ph: (509) 220-3834 | Mr Lynn A Peterson, MSN, CRNA
714 W Pine St,
Newport, WA 99156-9046
Ph: (509) 447-2441 |
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