Mrs Randa Sue Vajdak, PA-C is a medicare enrolled "Clinical Nurse Specialist - Medical-surgical" in Bryan, Texas. Her current practice location is
3740 Copperfield Dr., Ste 105, Bryan, Texas. You can reach out to her office (for appointments etc.) via phone at
(979) 776-1660.
Mrs Randa Sue Vajdak is licensed to practice in Texas (license number PA02991) 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 1902172125.
Provider's Profile
| Full Name | Mrs Randa Sue Vajdak |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Medical-surgical |
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| Location | 3740 Copperfield Dr., Bryan, Texas |
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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: 1902172125
- Provider Enumeration Date: 04/02/2012
- Last Update Date: 04/02/2012
Medicare PECOS Information:
- PECOS PAC ID: 8022265461
- Enrollment ID: I20120820001164
Medical Identifiers
Medical identifiers for Mrs Randa Sue Vajdak such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1902172125 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SM0705X | Clinical Nurse Specialist - Medical-surgical | PA02991 (Texas) | 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 Randa Sue Vajdak allows following entities to bill medicare on her behalf.
| Entity Name | Owens Interventional Pain Management PLLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134538093
PECOS PAC ID: 4587886510
Enrollment ID: O20141106002154 |
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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. Mrs Randa Sue Vajdak 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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Mrs Randa Sue Vajdak, PA-C
3740 Copperfield Dr., Ste 105,
Bryan, TX 77802
Ph: (979) 776-1660 | Mrs Randa Sue Vajdak, PA-C
3740 Copperfield Dr., Ste 105,
Bryan, TX 77802
Ph: (979) 776-1660 |
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