Andrew Wade Phippen, is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Holladay, Utah. His current practice location is
2960 E Casto Ln, Holladay, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 556-1866.
Andrew Wade Phippen is licensed to practice in Utah (license number 284016-2401) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1083069025.
Physician's Profile
| Full Name | Andrew Wade Phippen |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 2960 E Casto Ln, Holladay, Utah |
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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: 1083069025
- Provider Enumeration Date: 04/27/2016
- Last Update Date: 05/03/2021
Medicare PECOS Information:
- PECOS PAC ID: 0749697076
- Enrollment ID: I20210607000563
Medical Identifiers
Medical identifiers for Andrew Wade Phippen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1083069025 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | 284016-2401 (Utah) | 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. Andrew Wade Phippen allows following entities to bill medicare on his behalf.
| Entity Name | Elite Healthcare Providers Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346795325
PECOS PAC ID: 1658650361
Enrollment ID: O20161122000048 |
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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. Andrew Wade Phippen 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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Andrew Wade Phippen,
2960 E Casto Ln,
Holladay, UT 84117-7123
Ph: (801) 556-1866 | Andrew Wade Phippen,
2960 E Casto Ln,
Holladay, UT 84117-7123
Ph: (801) 556-1866 |
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