Mr William G Chisholm Jr, CRNA - Medicare Nurse Anesthetist, Certified Registered in Ilwaco, WA

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Mr William G Chisholm Jr, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Ilwaco, Washington. His current practice location is 174 1st Ave N, Ilwaco, Washington. You can reach out to his office (for appointments etc.) via phone at (360) 642-3181.

Mr William G Chisholm Jr is licensed to practice in Washington (license number AP30001327) 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 1396775938.

Contact Information

Mr William G Chisholm Jr, CRNA
174 1st Ave N,
Ilwaco, WA 98624-9137
(360) 642-3181
Not Available

Map and Direction




Provider's Profile

Full NameMr William G Chisholm Jr
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location174 1st Ave N, Ilwaco, Washington
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1396775938
  • Provider Enumeration Date: 07/03/2006
  • Last Update Date: 02/02/2016
  Medicare PECOS Information:
  • PECOS PAC ID: 5698774354
  • Enrollment ID: I20071115000037

Medical Identifiers

Medical identifiers for Mr William G Chisholm Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1396775938NPI-NPPES
9603887MedicaidWA
430073112OtherWAMEDICARE RAILROAD
210785MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered AP30001327 (Washington)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 William G Chisholm Jr allows following entities to bill medicare on his behalf.
Entity NameProvidence Wa Anesthesia Services, Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669615894
PECOS PAC ID: 9335298884
Enrollment ID: O20090513000135
Entity NameLake Washington Anesthesia Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1962935197
PECOS PAC ID: 3678840543
Enrollment ID: O20170524001681
Entity NameAnesthesia Dynamics Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073001012
PECOS PAC ID: 3779832530
Enrollment ID: O20201002002223

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 William G Chisholm Jr 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 AddressPractice Location Address
Mr William G Chisholm Jr, CRNA
91 E Tamarack Ln,
Shelton, WA 98584-9402

Ph: (360) 427-5747		Mr William G Chisholm Jr, CRNA
174 1st Ave N,
Ilwaco, WA 98624-9137

Ph: (360) 642-3181

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Ilwaco, WA

Betty S Miller, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 2142 Wecoma Pl, Ilwaco, WA 98624
Phone: 360-642-4821    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.