Derek Davis, PMHNP in Chaska, MN - Medicare Nurse Practitioner

Derek Davis, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" in Chaska, Minnesota. His current practice location is 1107 Hazeltine Blvd Ste 370, Chaska, Minnesota. You can reach out to his office (for appointments etc.) via phone at (952) 395-1441.

Derek Davis is licensed to practice in Minnesota (license number 10243) 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 1619668373.

Contact Information

	Derek Davis, PMHNP
	1107 Hazeltine Blvd Ste 370, Chaska, MN 55318-1009
	(952) 395-1441
	(952) 395-1442

Map and Direction

Provider's Profile

Full Name	Derek Davis
Gender	Male
Speciality	Nurse Practitioner - Psychiatric/mental Health
Location	1107 Hazeltine Blvd Ste 370, Chaska, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619668373
Provider Enumeration Date: 05/15/2023
Last Update Date: 06/02/2023

Medicare PECOS Information:

PECOS PAC ID: 5698137537
Enrollment ID: I20230809003650

Medical Identifiers

Medical identifiers for Derek Davis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619668373	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP0808X	Nurse Practitioner - Psychiatric/mental Health	10243 (Minnesota)	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. Derek Davis allows following entities to bill medicare on his behalf.

Entity Name	Nystrom & Associates Ltd
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396750188 PECOS PAC ID: 6406752492 Enrollment ID: O20031210000592

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. Derek Davis 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
Derek Davis, PMHNP 1900 Silver Lake Rd Nw Ste 110, New Brighton, MN 55112-1789 Ph: (651) 628-9566	Derek Davis, PMHNP 1107 Hazeltine Blvd Ste 370, Chaska, MN 55318-1009 Ph: (952) 395-1441

Reviews and Comments

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Caitlan Ann Muthyala, DNP, APRN, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 111 Hundertmark Rd, Chaska, MN 55318 Phone: 952-361-2450
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Melea Rae Anderson, PNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 3000 N Chestnut St, Suite 110, Chaska, MN 55318 Phone: 952-361-3999 Fax: 952-361-3995

Derek Davis, PMHNP - Medicare Nurse Practitioner in Chaska, MN