Adin Samuel Vaewsorn, RN, PMHNP in Oakland, CA

Adin Samuel Vaewsorn, RN, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Oakland, California. His current practice location is 1501 Fruitvale Ave, Oakland, California. You can reach out to his office (for appointments etc.) via phone at (510) 635-5200.

Adin Samuel Vaewsorn is licensed to practice in California (license number 95018370) 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 1932719192.

Contact Information

	Adin Samuel Vaewsorn, RN, PMHNP
	1501 Fruitvale Ave, Oakland, CA 94601-2322
	(510) 635-5200
	Not Available

Map and Direction

Provider's Profile

Full Name	Adin Samuel Vaewsorn
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1501 Fruitvale Ave, Oakland, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1932719192
Provider Enumeration Date: 08/03/2020
Last Update Date: 05/23/2022

Medicare PECOS Information:

PECOS PAC ID: 9234517657
Enrollment ID: I20220525002404

Medical Identifiers

Medical identifiers for Adin Samuel Vaewsorn such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1932719192	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	95204521 (California)	Secondary
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	95018370 (California)	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. Adin Samuel Vaewsorn allows following entities to bill medicare on his behalf.

Entity Name	La Clinica De La Raza Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144336181 PECOS PAC ID: 1557258282 Enrollment ID: O20040227001016

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. Adin Samuel Vaewsorn 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
Adin Samuel Vaewsorn, RN, PMHNP 1501 Fruitvale Ave, Oakland, CA 94601-2322 Ph: (510) 635-5200	Adin Samuel Vaewsorn, RN, PMHNP 1501 Fruitvale Ave, Oakland, CA 94601-2322 Ph: (510) 635-5200

Reviews and Comments

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Adin Samuel Vaewsorn, RN, PMHNP - Medicare Nurse Practitioner in Oakland, CA