Hazel Dawn Brogdon, is a medicare enrolled "Psychiatry & Neurology - Psychiatry" provider in Anchorage, Alaska. Her current practice location is
2600 Cordova St Ste 101, Anchorage, Alaska. You can reach out to her office (for appointments etc.) via phone at
(907) 279-9640.
Hazel Dawn Brogdon is licensed to practice in Washington (license number MD61326794) 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 1396232666.
Healthcare Provider's Profile
Full Name | Hazel Dawn Brogdon |
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Gender | Female |
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Speciality | Psychiatry & Neurology - Psychiatry |
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Location | 2600 Cordova St Ste 101, Anchorage, Alaska |
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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: 1396232666
- Provider Enumeration Date: 04/21/2018
- Last Update Date: 10/03/2024
Medicare PECOS Information:
- PECOS PAC ID: 6800269002
- Enrollment ID: I20230309002049
Medical Identifiers
Medical identifiers for Hazel Dawn Brogdon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1396232666 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | MD61326794 (Washington) | 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. Hazel Dawn Brogdon allows following entities to bill medicare on her behalf.
Entity Name | Providence Health & Services Washington |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1194099390 PECOS PAC ID: 0345139929 Enrollment ID: O20040311001453 |
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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. Hazel Dawn Brogdon 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 |
Hazel Dawn Brogdon, 2600 Cordova St Ste 101, Anchorage, AK 99503-2745 Ph: (907) 279-9640 | Hazel Dawn Brogdon, 2600 Cordova St Ste 101, Anchorage, AK 99503-2745 Ph: (907) 279-9640 |
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