Oghenetega Ewefada Vance, FNP is a medicare enrolled "Nurse Practitioner - Family" in Guadalupe, Arizona. Her current practice location is
5825 E Calle Guadalupe, Guadalupe, Arizona. You can reach out to her office (for appointments etc.) via phone at
(833) 855-9973.
Oghenetega Ewefada Vance is licensed to practice in Minnesota (license number F07210101) 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 1104416007.
Provider's Profile
| Full Name | Oghenetega Ewefada Vance |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 5825 E Calle Guadalupe, Guadalupe, Arizona |
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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: 1104416007
- Provider Enumeration Date: 01/25/2021
- Last Update Date: 09/27/2021
Medicare PECOS Information:
- PECOS PAC ID: 7416355714
- Enrollment ID: I20211015002293
Medical Identifiers
Medical identifiers for Oghenetega Ewefada Vance such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104416007 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 2150369 (Minnesota) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | F07210101 (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. Oghenetega Ewefada Vance allows following entities to bill medicare on her behalf.
| Entity Name | District Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336472448
PECOS PAC ID: 7315086691
Enrollment ID: O20091125000583 |
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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. Oghenetega Ewefada Vance 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 |
|---|
Oghenetega Ewefada Vance, FNP
5825 E Calle Guadalupe,
Guadalupe, AZ 85283-2664
Ph: (480) 344-6000 | Oghenetega Ewefada Vance, FNP
5825 E Calle Guadalupe,
Guadalupe, AZ 85283-2664
Ph: (833) 855-9973 |
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