Mrs Pandora Bazen Dickson, - Medicare Nurse Practitioner in Champlin, MN

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Mrs Pandora Bazen Dickson, is a medicare enrolled "Nurse Practitioner - Family" in Champlin, Minnesota. Her current practice location is 7400 122nd Ave N, Champlin, Minnesota. You can reach out to her office (for appointments etc.) via phone at (763) 458-2415.

Mrs Pandora Bazen Dickson is licensed to practice in Minnesota (license number 7270) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1578101747.

Contact Information

Mrs Pandora Bazen Dickson,
7400 122nd Ave N,
Champlin, MN 55316-2127
(763) 458-2415
Not Available

Map and Direction




Provider's Profile

Full NameMrs Pandora Bazen Dickson
GenderFemale
SpecialityNurse Practitioner - Family
Location7400 122nd Ave N, Champlin, Minnesota
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1578101747
  • Provider Enumeration Date: 12/18/2019
  • Last Update Date: 06/14/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 4183038102
  • Enrollment ID: I20210202001667

Medical Identifiers

Medical identifiers for Mrs Pandora Bazen Dickson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578101747NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163WM0705XRegistered Nurse - Medical-surgical R188972-5 (Minnesota)Secondary
363LF0000XNurse Practitioner - Family 7270 (Minnesota)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. Mrs Pandora Bazen Dickson allows following entities to bill medicare on her behalf.
Entity NameIntegrated Wound Care Minnesota PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1205390457
PECOS PAC ID: 2769722511
Enrollment ID: O20190314001268

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. Mrs Pandora Bazen Dickson 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 AddressPractice Location Address
Mrs Pandora Bazen Dickson,
7400 122nd Ave N,
Champlin, MN 55316-2127

Ph: (763) 458-2415		Mrs Pandora Bazen Dickson,
7400 122nd Ave N,
Champlin, MN 55316-2127

Ph: (763) 458-2415

Reviews and Comments


Nurse Practitioner Nurses in Champlin, MN

Mrs. Olitha Jamesetta Fofana, AGPCNP-BC
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Prince Nde Aloh,
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Renee Sara Leisen Fisher, FNP-C
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Phone: 763-316-9487    
Janet M Siciliano, NP
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Practice Location: 11269 Jefferson Hwy N, Champlin, MN 55316
Phone: 612-427-9620    Fax: 612-247-9626

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

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