Clifford Lee Hazelwood, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Hodgenville, Kentucky. He went to Kentucky School Of Medicine and graduated in 2021 and has 4 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). He is a member of the group practice Professional Anesthesia Services Of Kentucky Pllc and his current practice location is
4470 Bardstown Rd, Hodgenville, Kentucky. You can reach out to his office (for appointments etc.) via phone at
(270) 763-3313.
Clifford Lee Hazelwood is licensed to practice in Kentucky (license number 3017161) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1689340374.
Provider's Profile
| Full Name | Clifford Lee Hazelwood |
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| Gender | Male |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 4 Years |
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| Location | 4470 Bardstown Rd, Hodgenville, Kentucky |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Clifford Lee Hazelwood attended and graduated from Kentucky School Of Medicine in 2021
NPI Data:
- NPI Number: 1689340374
- Provider Enumeration Date: 08/21/2021
- Last Update Date: 01/06/2023
Medicare PECOS Information:
- PECOS PAC ID: 6800280421
- Enrollment ID: I20220316003524
Medical Identifiers
Medical identifiers for Clifford Lee Hazelwood such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1689340374 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 1092982 (Kentucky) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 3017161 (Kentucky) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Professional Anesthesia Services Of Kentucky Pllc | 0244590305 | 146 |
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. Clifford Lee Hazelwood allows following entities to bill medicare on his behalf.
| Entity Name | Professional Anesthesia Services Of Kentucky Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992212807
PECOS PAC ID: 0244590305
Enrollment ID: O20180209000936 |
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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. Clifford Lee Hazelwood 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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Clifford Lee Hazelwood,
4470 Bardstown Rd,
Hodgenville, KY 42748-9313
Ph: (270) 786-3313 | Clifford Lee Hazelwood,
4470 Bardstown Rd,
Hodgenville, KY 42748-9313
Ph: (270) 763-3313 |
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