Rachel Carol Mathisen, is a medicare enrolled "Nurse Practitioner - Family" in Wagener, South Carolina. Her current practice location is
120 Louie St, Wagener, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 564-8803.
Rachel Carol Mathisen is licensed to practice in South Carolina (license number 20972) 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 1679009724.
Provider's Profile
| Full Name | Rachel Carol Mathisen |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 120 Louie St, Wagener, South Carolina |
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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: 1679009724
- Provider Enumeration Date: 05/11/2017
- Last Update Date: 05/11/2017
Medicare PECOS Information:
- PECOS PAC ID: 6608149349
- Enrollment ID: I20170831002513
Medical Identifiers
Medical identifiers for Rachel Carol Mathisen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1679009724 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 20972 (South Carolina) | 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. Rachel Carol Mathisen allows following entities to bill medicare on her behalf.
| Entity Name | Town Of Wagener South Carolina |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336516921
PECOS PAC ID: 5092014274
Enrollment ID: O20180717001995 |
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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. Rachel Carol Mathisen 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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Rachel Carol Mathisen,
5200 Greystone Summit Dr, Apt 308,
Columbus, GA 31909-7541
Ph: (732) 533-8708 | Rachel Carol Mathisen,
120 Louie St,
Wagener, SC 29164-9445
Ph: (803) 564-8803 |
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