Nicole Jasmin Burgis, AUD is a medicare enrolled "Audiologist" provider in San Carlos, California. Her current practice location is
301 Industrial Rd, San Carlos, California. You can reach out to her office (for appointments etc.) via phone at
(650) 596-4210.
Nicole Jasmin Burgis is licensed to practice in California (license number 3558) 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 1063028207.
Healthcare Provider's Profile
| Full Name | Nicole Jasmin Burgis |
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| Gender | Female |
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| Speciality | Audiologist |
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| Location | 301 Industrial Rd, San Carlos, California |
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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: 1063028207
- Provider Enumeration Date: 09/22/2020
- Last Update Date: 01/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 0143690511
- Enrollment ID: I20221228003098
Medical Identifiers
Medical identifiers for Nicole Jasmin Burgis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063028207 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 231H00000X | Audiologist | 3558 (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. Nicole Jasmin Burgis allows following entities to bill medicare on her behalf.
| Provider Name | Sutter Bay Medical Foundation |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1013950807
PECOS PAC ID: 4284538778
Enrollment ID: O20031125000909 |
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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. Nicole Jasmin Burgis 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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Nicole Jasmin Burgis, AUD
325 Distel Cir,
Los Altos, CA 94022-1408
Ph: (650) 596-4210 | Nicole Jasmin Burgis, AUD
301 Industrial Rd,
San Carlos, CA 94070-2603
Ph: (650) 596-4210 |
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