Derek David Czywczynski, OD is a medicare enrolled "Optometrist" provider in Hazen, North Dakota. He went to Southern California College Of Optometry and graduated in 2009 and has 15 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Sanford Health Of Northern Minnesota and his current practice location is
104 12th Ave Nw, Suite #1, Hazen, North Dakota. You can reach out to his office (for appointments etc.) via phone at
(701) 748-5220.
Derek David Czywczynski is licensed to practice in North Dakota (license number 681) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1427281583.
Healthcare Provider's Profile
| Full Name | Derek David Czywczynski |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 15 Years |
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| Location | 104 12th Ave Nw, Hazen, North Dakota |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Derek David Czywczynski attended and graduated from Southern California College Of Optometry in 2009
NPI Data:
- NPI Number: 1427281583
- Provider Enumeration Date: 08/24/2009
- Last Update Date: 03/31/2022
Medicare PECOS Information:
- PECOS PAC ID: 0648316646
- Enrollment ID: I20200521000589
Medical Identifiers
Medical identifiers for Derek David Czywczynski such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427281583 | NPI | - | NPPES |
| 60698 | Medicaid | ND | |
| 893357 | Other | ND | NORTH DAKOTA VISION SERVICES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 1340 (Nebraska) | Secondary |
| 152W00000X | Optometrist | 681 (North Dakota) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Sanford Health Of Northern Minnesota | 5597725168 | 258 |
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. Derek David Czywczynski allows following entities to bill medicare on his behalf.
| Provider Name | Sanford Health Of Northern Minnesota |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1770849697
PECOS PAC ID: 5597725168
Enrollment ID: O20041025000442 |
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| Provider Name | Sanford Health Of Northern Minnesota |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1265829881
PECOS PAC ID: 5597725168
Enrollment ID: O20150602000945 |
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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. Derek David Czywczynski 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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Derek David Czywczynski, OD
104 12th Ave Nw, Suite #1,
Hazen, ND 58545-4100
Ph: (701) 748-5220 | Derek David Czywczynski, OD
104 12th Ave Nw, Suite #1,
Hazen, ND 58545-4100
Ph: (701) 748-5220 |
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