Mr Jeffrey Dale Schultz, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Valley City, North Dakota. His current practice location is
570 Chautauqua Blvd, Valley City, North Dakota. You can reach out to his office (for appointments etc.) via phone at
(701) 845-6400.
Mr Jeffrey Dale Schultz is licensed to practice in North Dakota (license number R31111) 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 1962409490.
Provider's Profile
| Full Name | Mr Jeffrey Dale Schultz |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 570 Chautauqua Blvd, Valley City, North Dakota |
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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: 1962409490
- Provider Enumeration Date: 06/30/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 4183685779
- Enrollment ID: I20121029000753
Medical Identifiers
Medical identifiers for Mr Jeffrey Dale Schultz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962409490 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R31111 (North Dakota) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | R022879 (South Dakota) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | R136952-0 (Minnesota) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 647231 (Texas) | Secondary |
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 Jeffrey Dale Schultz allows following entities to bill medicare on his behalf.
| Entity Name | Anesthesia Dynamics Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073001012
PECOS PAC ID: 3779832530
Enrollment ID: O20200422002521 |
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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. Mr Jeffrey Dale Schultz 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 Jeffrey Dale Schultz, CRNA
845 6th Ave Ne, Apt 11,
Valley City, ND 58072-2364
Ph: (710) 845-0715 | Mr Jeffrey Dale Schultz, CRNA
570 Chautauqua Blvd,
Valley City, ND 58072-3145
Ph: (701) 845-6400 |
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