Dominique Elycia Sturdivant, RN in Bethlehem, PA - Medicare Nurse Anesthetist, Certified Registered

Dominique Elycia Sturdivant, RN is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Bethlehem, Pennsylvania. Her current practice location is 801 Ostrum St, Bethlehem, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at (484) 426-8000.

Dominique Elycia Sturdivant is licensed to practice in Pennsylvania (license number RN660911) 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 1144952193.

Contact Information

	Dominique Elycia Sturdivant, RN
	801 Ostrum St, Bethlehem, PA 18015-1000
	(484) 426-8000
	Not Available

Map and Direction

Provider's Profile

Full Name	Dominique Elycia Sturdivant
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	801 Ostrum St, Bethlehem, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1144952193
Provider Enumeration Date: 06/28/2022
Last Update Date: 11/25/2022

Medicare PECOS Information:

PECOS PAC ID: 1456721893
Enrollment ID: I20221230000409

Medical Identifiers

Medical identifiers for Dominique Elycia Sturdivant such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1144952193	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163WP0200X	Registered Nurse - Pediatrics	RN660911 (Pennsylvania)	Secondary
367500000X	Nurse Anesthetist, Certified Registered	RN660911 (Pennsylvania)	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. Dominique Elycia Sturdivant allows following entities to bill medicare on her behalf.

Entity Name	Anesthesia Specialists Of Bethlehem Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1851349302 PECOS PAC ID: 1355254533 Enrollment ID: O20031112000676

Entity Name	Lehigh Valley Anesthesia Services, P. C.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730174731 PECOS PAC ID: 8820992183 Enrollment ID: O20031120000076

Entity Name	Lehigh Valley Physician Group
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1457309650 PECOS PAC ID: 3072425123 Enrollment ID: O20040227000335

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. Dominique Elycia Sturdivant 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
Dominique Elycia Sturdivant, RN Po Box 5520, Bethlehem, PA 18015-0520 Ph: () -	Dominique Elycia Sturdivant, RN 801 Ostrum St, Bethlehem, PA 18015-1000 Ph: (484) 426-8000

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Bethlehem, PA

Dr. Amy Lynn Morrissey, DNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Ostrum St, Bethlehem, PA 18015 Phone: 610-954-5810 Fax: 610-954-5480
Andrew Hornick, DNP, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Ostrum St, Bethlehem, PA 18015 Phone: 610-954-5810
Bohdan Khromenko, Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 3659 Ironstone Rd, Bethlehem, PA 18020 Phone: 267-575-3619
Elaine Carboni, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 425 Brighton St, # 202, Bethlehem, PA 18015 Phone: 610-954-8040
Ms. Diane M. Gaw, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 801 Ostrum St, Bethlehem, PA 18015 Phone: 610-954-5810 Fax: 610-954-5480
Mr. Humberto Ortiz Jr., CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 W Broad St, Bethlehem, PA 18018 Phone: 610-954-8040
Christine M Rutkowski, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 425 Brighton St, # 202, Bethlehem, PA 18015 Phone: 610-954-8040

Dominique Elycia Sturdivant, RN - Medicare Nurse Anesthetist, Certified Registered in Bethlehem, PA