Mrs Nicole Evans Blanck, MS, CCC-A is a medicare enrolled "Audiologist" provider in Richmond, California. Her current practice location is
901 Nevin Ave, Hns Department, Richmond, California. You can reach out to her office (for appointments etc.) via phone at
(510) 307-2364.
Mrs Nicole Evans Blanck is licensed to practice in California (license number AU2425) 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 1518024744.
Healthcare Provider's Profile
Full Name | Mrs Nicole Evans Blanck |
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Gender | Female |
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Speciality | Audiologist |
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Location | 901 Nevin Ave, Richmond, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1518024744
- Provider Enumeration Date: 01/03/2007
- Last Update Date: 01/03/2022
Medicare PECOS Information:
- PECOS PAC ID: 0840428934
- Enrollment ID: I20140117000712
Medical Identifiers
Medical identifiers for Mrs Nicole Evans Blanck such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1518024744 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
231H00000X | Audiologist | AU2425 (California) | 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. Mrs Nicole Evans Blanck allows following entities to bill medicare on her behalf.
Provider Name | Permanente Medical Group Inc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
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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. Mrs Nicole Evans Blanck 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 |
Mrs Nicole Evans Blanck, MS, CCC-A 2923 Webster St Ste 201, Oakland, CA 94609-3418 Ph: () - | Mrs Nicole Evans Blanck, MS, CCC-A 901 Nevin Ave, Hns Department, Richmond, CA 94801-3143 Ph: (510) 307-2364 |
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