Mr Blaine Christopher Van Ausdeln, FNP-C, MS in Stockton, CA

Mr Blaine Christopher Van Ausdeln, FNP-C, MS is a medicare enrolled "Nurse Practitioner - Family" in Stockton, California. His current practice location is 7373 West Ln, Stockton, California. You can reach out to his office (for appointments etc.) via phone at (209) 476-3569.

Mr Blaine Christopher Van Ausdeln is licensed to practice in California (license number 326768/4523) 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 1194720144.

Contact Information

	Mr Blaine Christopher Van Ausdeln, FNP-C, MS
	7373 West Ln, Stockton, CA 95210-3377
	(209) 476-3569
	(209) 476-3675

Map and Direction

Provider's Profile

Full Name	Mr Blaine Christopher Van Ausdeln
Gender	Male
Speciality	Nurse Practitioner - Family
Location	7373 West Ln, Stockton, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1194720144
Provider Enumeration Date: 06/16/2005
Last Update Date: 07/09/2007

Medicare PECOS Information:

PECOS PAC ID: 6305872987
Enrollment ID: I20050714000747

Medical Identifiers

Medical identifiers for Mr Blaine Christopher Van Ausdeln such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1194720144	NPI	-	NPPES
RN326768	Other	CA	MEDICAL PROVIDER ID

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	326768/4523 (California)	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. Mr Blaine Christopher Van Ausdeln allows following entities to bill medicare on his behalf.

Entity Name	Permanente Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710

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. Mr Blaine Christopher Van Ausdeln 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
Mr Blaine Christopher Van Ausdeln, FNP-C, MS 7373 West Ln, Stockton, CA 95210-3377 Ph: (209) 476-3569	Mr Blaine Christopher Van Ausdeln, FNP-C, MS 7373 West Ln, Stockton, CA 95210-3377 Ph: (209) 476-3569

Reviews and Comments

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Mr Blaine Christopher Van Ausdeln, FNP-C, MS - Medicare Nurse Practitioner in Stockton, CA