Mrs Amber Marie Dwan Grassman, RN/BSN is a medicare enrolled "Nurse Practitioner - Gerontology" in Dalton, Ohio. Her current practice location is
13984 Lake Court Dr, Dalton, Ohio. You can reach out to her office (for appointments etc.) via phone at
(330) 749-2044.
Mrs Amber Marie Dwan Grassman is licensed to practice in Ohio (license number APRN.CNP.0033608) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1629643242.
Provider's Profile
Full Name | Mrs Amber Marie Dwan Grassman |
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Gender | Female |
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Speciality | Nurse Practitioner - Gerontology |
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Location | 13984 Lake Court Dr, Dalton, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1629643242
- Provider Enumeration Date: 05/25/2021
- Last Update Date: 07/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 3476815044
- Enrollment ID: I20230509002720
Medical Identifiers
Medical identifiers for Mrs Amber Marie Dwan Grassman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1629643242 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | 364169 (Ohio) | Secondary |
363LG0600X | Nurse Practitioner - Gerontology | APRN.CNP.0033608 (Ohio) | 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. Mrs Amber Marie Dwan Grassman allows following entities to bill medicare on her behalf.
Entity Name | Extended Care Specialists, Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1134146079 PECOS PAC ID: 2466407713 Enrollment ID: O20190522003072 |
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Entity Name | Eventus Wholehealth Midwest Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1386252757 PECOS PAC ID: 4183040470 Enrollment ID: O20211214001579 |
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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. Mrs Amber Marie Dwan Grassman 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 |
Mrs Amber Marie Dwan Grassman, RN/BSN 13984 Lake Court Dr, Dalton, OH 44618-9291 Ph: (330) 749-2044 | Mrs Amber Marie Dwan Grassman, RN/BSN 13984 Lake Court Dr, Dalton, OH 44618-9291 Ph: (330) 749-2044 |
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