Kaela Pivnick, RD is a medicare enrolled "Dietitian, Registered" provider in Yelm, Washington. Her current practice location is
201 Tahoma Blvd, Ste 207, Yelm, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 458-6400.
Kaela Pivnick is licensed to practice in Washington (license number DI60650422) 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 1215479209.
Healthcare Provider's Profile
| Full Name | Kaela Pivnick |
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| Gender | Female |
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| Speciality | Dietitian, Registered |
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| Location | 201 Tahoma Blvd, Yelm, Washington |
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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: 1215479209
- Provider Enumeration Date: 11/08/2016
- Last Update Date: 11/09/2016
Medicare PECOS Information:
- PECOS PAC ID: 0749567790
- Enrollment ID: I20220804002593
Medical Identifiers
Medical identifiers for Kaela Pivnick such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1215479209 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | DI60650422 (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. Kaela Pivnick allows following entities to bill medicare on her behalf.
| Provider Name | Ilivewell Nutrition Therapy, Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1093150070
PECOS PAC ID: 5496186009
Enrollment ID: O20200515000498 |
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| Provider Name | Nourish, Inc. |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1558097824
PECOS PAC ID: 1557724937
Enrollment ID: O20230901000471 |
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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. Kaela Pivnick 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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Kaela Pivnick, RD
790 Remington Blvd,
Bolingbrook, IL 60440-4909
Ph: (630) 296-2222 | Kaela Pivnick, RD
201 Tahoma Blvd, Ste 207,
Yelm, WA 98597-7735
Ph: (360) 458-6400 |
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