Timothy Vanderweide, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Scott City, Kansas. His current practice location is
201 Albert Ave, Scott City, Kansas. You can reach out to his office (for appointments etc.) via phone at
(620) 872-5811.
Timothy Vanderweide is licensed to practice in Kansas (license number 557379) 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 1023482072.
Provider's Profile
| Full Name | Timothy Vanderweide |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 201 Albert Ave, Scott City, Kansas |
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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: 1023482072
- Provider Enumeration Date: 11/13/2015
- Last Update Date: 12/28/2017
Medicare PECOS Information:
- PECOS PAC ID: 6002111697
- Enrollment ID: I20160218002017
Medical Identifiers
Medical identifiers for Timothy Vanderweide such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1023482072 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 13-112281-051 (Kansas) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 557379 (Kansas) | 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. Timothy Vanderweide allows following entities to bill medicare on his behalf.
| Entity Name | New Wave Anesthesia Service Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811474760
PECOS PAC ID: 7719237494
Enrollment ID: O20180829003218 |
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| Entity Name | Steel Anesthesia Services Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952914277
PECOS PAC ID: 3173941549
Enrollment ID: O20200916002717 |
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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. Timothy Vanderweide 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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Timothy Vanderweide, CRNA
201 Albert Ave,
Scott City, KS 67871
Ph: (620) 872-5811 | Timothy Vanderweide, CRNA
201 Albert Ave,
Scott City, KS 67871
Ph: (620) 872-5811 |
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