John Pemberton, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Oak Park, Michigan. His current practice location is
23491 Norwood St, Oak Park, Michigan. You can reach out to his office (for appointments etc.) via phone at
(248) 495-9694.
John Pemberton is licensed to practice in Michigan (license number 4704327563) 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 1093406514.
Provider's Profile
| Full Name | John Pemberton |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 23491 Norwood St, Oak Park, Michigan |
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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: 1093406514
- Provider Enumeration Date: 05/16/2023
- Last Update Date: 08/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 8325492663
- Enrollment ID: I20230920003715
Medical Identifiers
Medical identifiers for John Pemberton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1093406514 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 4704327563 (Michigan) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 4704327563 (Michigan) | 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. John Pemberton allows following entities to bill medicare on his behalf.
| Entity Name | Botsford General Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235179664
PECOS PAC ID: 2668385238
Enrollment ID: O20031113000500 |
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| Entity Name | Northstar Anesthesia Of Michigan Iii Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972126209
PECOS PAC ID: 7911325469
Enrollment ID: O20200915001990 |
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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. John Pemberton 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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John Pemberton, CRNA
23491 Norwood St,
Oak Park, MI 48237-2203
Ph: (248) 495-9694 | John Pemberton, CRNA
23491 Norwood St,
Oak Park, MI 48237-2203
Ph: (248) 495-9694 |
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