Mikayla Marie Van Dervoort, PA-C is a
Physician Assistant based in Westtown, New York. Mikayla Marie Van Dervoort is licensed to practice in * (Not Available) (license number ) and her current practice location is
355 Route 284, Westtown, New York. She can be reached at her office (for appointments etc.) via phone at
(845) 772-1249.
NPI number for Mikayla Marie Van Dervoort is 1649014614 and her current mailing address is 355 Route 284, Westtown, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1649014614.
Provider's Profile
Full Name | Mikayla Marie Van Dervoort |
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Gender | Female |
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Speciality | Physician Assistant |
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Location | 355 Route 284, Westtown, New York |
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Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1649014614
- Provider Enumeration Date: 06/24/2024
- Last Update Date: 06/24/2024
Medical Identifiers
Medical identifiers for Mikayla Marie Van Dervoort such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1649014614 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | (* (Not Available)) | Primary |
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. Mikayla Marie Van Dervoort is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mikayla Marie Van Dervoort, PA-C 355 Route 284, Westtown, NY 10998-3441 Ph: (845) 772-1249 | Mikayla Marie Van Dervoort, PA-C 355 Route 284, Westtown, NY 10998-3441 Ph: (845) 772-1249 |
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