Nicholas Tyler Russenberger, MPAS is a medicare enrolled "Physician Assistant" in Buffalo, Oklahoma. He graduated from nursing school in 2023 and has 3 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Harper County Community Hospital and his current practice location is
1003 Us Highway 64, Buffalo, Oklahoma. You can reach out to his office (for appointments etc.) via phone at
(580) 735-2555.
Nicholas Tyler Russenberger is licensed to practice in Oklahoma (license number 5175) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1487435053.
Provider's Profile
| Full Name | Nicholas Tyler Russenberger |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 3 Years |
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| Location | 1003 Us Highway 64, Buffalo, Oklahoma |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Nicholas Tyler Russenberger graduated from nursing school in 2023
NPI Data:
- NPI Number: 1487435053
- Provider Enumeration Date: 10/10/2023
- Last Update Date: 10/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 8426405796
- Enrollment ID: I20231108000398
Medical Identifiers
Medical identifiers for Nicholas Tyler Russenberger such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1487435053 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 5175 (Oklahoma) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Harper County Community Hospital | 9638081433 | 4 |
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. Nicholas Tyler Russenberger 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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Nicholas Tyler Russenberger, MPAS
Po Box 677,
Buffalo, OK 73834-0677
Ph: (501) 215-1468 | Nicholas Tyler Russenberger, MPAS
1003 Us Highway 64,
Buffalo, OK 73834-8912
Ph: (580) 735-2555 |
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