Nita Kofchock, is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" physician in Tucson, Arizona. Her current practice location is
2802 E District St, Tucson, Arizona. You can reach out to her office (for appointments etc.) via phone at
(520) 301-2400.
Nita Kofchock is licensed to practice in Washington (license number AP60291694) 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 1174851695.
Physician's Profile
| Full Name | Nita Kofchock |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 2802 E District St, Tucson, Arizona |
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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: 1174851695
- Provider Enumeration Date: 11/20/2009
- Last Update Date: 06/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 9234382136
- Enrollment ID: I20150720000730
Medical Identifiers
Medical identifiers for Nita Kofchock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174851695 | NPI | - | NPPES |
| AP60291694 | Other | WA | WASHINGTON STATE LICENSE |
| 094362 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 201710096NP-PP (Oregon) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | AP8509 (Arizona) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | AP60291694 (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. Nita Kofchock allows following entities to bill medicare on her behalf.
| Entity Name | University Of Utah Adult Services |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114321981
PECOS PAC ID: 0941525273
Enrollment ID: O20150209001683 |
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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. Nita Kofchock 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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Nita Kofchock,
202 E Earll Dr Ste 200,
Phoenix, AZ 85012-2647
Ph: (602) 808-2800 | Nita Kofchock,
2802 E District St,
Tucson, AZ 85714-2081
Ph: (520) 301-2400 |
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