Nicole Elizabeth Amstutz, CNM is a medicare enrolled "Advanced Practice Midwife" in Ogden, Utah. Her current practice location is
5319 S 500 E Ste C, Ogden, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 917-6104.
Nicole Elizabeth Amstutz is licensed to practice in California (license number 236130) 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 1902406929.
Provider's Profile
| Full Name | Nicole Elizabeth Amstutz |
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| Gender | Female |
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| Speciality | Advanced Practice Midwife |
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| Location | 5319 S 500 E Ste C, Ogden, Utah |
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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: 1902406929
- Provider Enumeration Date: 10/28/2020
- Last Update Date: 10/15/2024
Medicare PECOS Information:
- PECOS PAC ID: 9133577984
- Enrollment ID: I20231205000464
Medical Identifiers
Medical identifiers for Nicole Elizabeth Amstutz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1902406929 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 367A00000X | Advanced Practice Midwife | 236130 (California) | 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. Nicole Elizabeth Amstutz allows following entities to bill medicare on her behalf.
| Entity Name | Southern California Permanente Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316979834 PECOS PAC ID: 6002729175 Enrollment ID: O20040126000823 |
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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. Nicole Elizabeth Amstutz 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 |
Nicole Elizabeth Amstutz, CNM 489 La Floresta Dr, Brea, CA 92823-6312 Ph: (831) 297-8852 | Nicole Elizabeth Amstutz, CNM 5319 S 500 E Ste C, Ogden, UT 84405-7218 Ph: (801) 917-6104 |
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