Dana Sue Mathis, FNP is a medicare enrolled "Nurse Practitioner - Family" in Tanana, Alaska. Her current practice location is
150 Front St, Tanana, Alaska. You can reach out to her office (for appointments etc.) via phone at
(907) 656-1366.
Dana Sue Mathis is licensed to practice in Alaska (license number NURU1318) 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 1568643831.
Provider's Profile
| Full Name | Dana Sue Mathis |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Family |
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| Location | 150 Front St, Tanana, Alaska |
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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: 1568643831
- Provider Enumeration Date: 11/15/2007
- Last Update Date: 06/10/2021
Medicare PECOS Information:
- PECOS PAC ID: 9739231549
- Enrollment ID: I20090708000600
Medical Identifiers
Medical identifiers for Dana Sue Mathis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568643831 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | 5959090-4405 (Utah) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | NURU1318 (Alaska) | 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. Dana Sue Mathis allows following entities to bill medicare on her behalf.
| Entity Name | Southeast Alaska Regional Health Consortium |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376758037
PECOS PAC ID: 1456265362
Enrollment ID: O20031114000631 |
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| Entity Name | Tanana Chiefs Conference |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1821201278
PECOS PAC ID: 9537050109
Enrollment ID: O20050111000954 |
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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. Dana Sue Mathis 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 |
|---|
Dana Sue Mathis, FNP
1124 W Riverside Ave Ste 400,
Spokane, WA 99201-1109
Ph: (907) 656-1366 | Dana Sue Mathis, FNP
150 Front St,
Tanana, AK 99777
Ph: (907) 656-1366 |
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