Richard Edward Cooksley, PA is a medicare enrolled "Physician Assistant - Medical" in Canyonville, Oregon. His current practice location is
115 S Pine St, Canyonville, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 839-4211.
Richard Edward Cooksley is licensed to practice in Oregon (license number PA00272) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1942271192.
Provider's Profile
| Full Name | Richard Edward Cooksley |
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| Gender | Male |
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| Speciality | Physician Assistant - Medical |
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| Location | 115 S Pine St, Canyonville, Oregon |
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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: 1942271192
- Provider Enumeration Date: 01/27/2006
- Last Update Date: 10/18/2018
Medicare PECOS Information:
- PECOS PAC ID: 4486717378
- Enrollment ID: I20090121000139
Medical Identifiers
Medical identifiers for Richard Edward Cooksley such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942271192 | NPI | - | NPPES |
| 930087876 | Other | OR | RAILROAD MEDICARE |
| PA00272 | Other | OR | STATE LICENSE |
| 165878 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | PA00272 (Oregon) | Primary |
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. Richard Edward Cooksley 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 |
|---|
Richard Edward Cooksley, PA
Po Box 888,
Canyonville, OR 97417-0888
Ph: (541) 839-4211 | Richard Edward Cooksley, PA
115 S Pine St,
Canyonville, OR 97417-9648
Ph: (541) 839-4211 |
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