Andrea L Nutt, FNP is a medicare enrolled "Nurse Practitioner - Family" in Sheridan, Oregon. Her current practice location is
222 Se Jefferson St, Sheridan, Oregon. You can reach out to her office (for appointments etc.) via phone at
(503) 843-1535.
Andrea L Nutt is licensed to practice in Oregon (license number 201705780NP-PP) 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 1093192965.
Provider's Profile
Full Name | Andrea L Nutt |
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Gender | Female |
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Speciality | Nurse Practitioner - Family |
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Location | 222 Se Jefferson St, Sheridan, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1093192965
- Provider Enumeration Date: 04/29/2015
- Last Update Date: 08/09/2023
Medicare PECOS Information:
- PECOS PAC ID: 0547533325
- Enrollment ID: I20170829004196
Medical Identifiers
Medical identifiers for Andrea L Nutt such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093192965 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363LF0000X | Nurse Practitioner - Family | 201705780NP-PP (Oregon) | 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. Andrea L Nutt allows following entities to bill medicare on her behalf.
Entity Name | Northwest Medical Foundation Of Tillamook |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1871575225 PECOS PAC ID: 5092619569 Enrollment ID: O20031208000676 |
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Entity Name | Icco Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1407004757 PECOS PAC ID: 1355406729 Enrollment ID: O20090218000510 |
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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. Andrea L Nutt 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 |
Andrea L Nutt, FNP Po Box 1023, Roseburg, OR 97470-0232 Ph: (541) 440-6390 | Andrea L Nutt, FNP 222 Se Jefferson St, Sheridan, OR 97378-1924 Ph: (503) 843-1535 |
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