Mr Timothy Bart Johnson, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Broken Bow, Nebraska. His current practice location is
79568 Sumner Road, Broken Bow, Nebraska. You can reach out to his office (for appointments etc.) via phone at
(308) 872-2294.
Mr Timothy Bart Johnson is licensed to practice in Nebraska (license number 100588) 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 1588764583.
Provider's Profile
| Full Name | Mr Timothy Bart Johnson |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 79568 Sumner Road, Broken Bow, Nebraska |
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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: 1588764583
- Provider Enumeration Date: 09/22/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8729061965
- Enrollment ID: I20040609001257
Medical Identifiers
Medical identifiers for Mr Timothy Bart Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1588764583 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 367500000X | Nurse Anesthetist, Certified Registered | 100588 (Nebraska) | 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 Timothy Bart Johnson allows following entities to bill medicare on his behalf.
| Entity Name | Jennie M Melham Memorial Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366659773 PECOS PAC ID: 5799766440 Enrollment ID: O20040527000928 |
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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 Timothy Bart Johnson 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 Timothy Bart Johnson, CRNA 79568 Sumner Road, Broken Bow, NE 68822 Ph: (308) 872-2294 | Mr Timothy Bart Johnson, CRNA 79568 Sumner Road, Broken Bow, NE 68822 Ph: (308) 872-2294 |
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