Bristyn D Vickers, AGACNP is a medicare enrolled "Nurse Practitioner - Acute Care" physician in Lubbock, Texas. Her current practice location is
3621 22nd St Ste 400, Lubbock, Texas. You can reach out to her office (for appointments etc.) via phone at
(806) 791-8484.
Bristyn D Vickers is licensed to practice in Texas (license number 1094003) 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 1942922919.
Physician's Profile
| Full Name | Bristyn D Vickers |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Acute Care |
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| Location | 3621 22nd St Ste 400, Lubbock, Texas |
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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: 1942922919
- Provider Enumeration Date: 09/15/2022
- Last Update Date: 10/24/2022
Medicare PECOS Information:
- PECOS PAC ID: 5890164412
- Enrollment ID: I20221202002491
Medical Identifiers
Medical identifiers for Bristyn D Vickers such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1942922919 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208M00000X | Hospitalist | 1094003 (Texas) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 1094003 (Texas) | 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. Bristyn D Vickers allows following entities to bill medicare on her behalf.
| Entity Name | Covenant Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376598904
PECOS PAC ID: 6901889393
Enrollment ID: O20040608000563 |
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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. Bristyn D Vickers 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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Bristyn D Vickers, AGACNP
2215 Nashville Ave,
Lubbock, TX 79410-1105
Ph: (806) 725-5844 | Bristyn D Vickers, AGACNP
3621 22nd St Ste 400,
Lubbock, TX 79410-1302
Ph: (806) 791-8484 |
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