Mrs Kristine Ericksen-miller, NP in Newport Beach, CA

Mrs Kristine Ericksen-miller, NP is a medicare enrolled "Nurse Practitioner - Primary Care" in Newport Beach, California. Her current practice location is 4321 Birch St Ste 100, Newport Beach, California. You can reach out to her office (for appointments etc.) via phone at (310) 245-6503.

Mrs Kristine Ericksen-miller is licensed to practice in California (license number 95004881) 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 1174079115.

Contact Information

	Mrs Kristine Ericksen-miller, NP
	4321 Birch St Ste 100, Newport Beach, CA 92660-1940
	(310) 245-6503
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Kristine Ericksen-miller
Gender	Female
Speciality	Nurse Practitioner - Primary Care
Location	4321 Birch St Ste 100, Newport Beach, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1174079115
Provider Enumeration Date: 08/30/2016
Last Update Date: 10/16/2018

Medicare PECOS Information:

PECOS PAC ID: 3779865670
Enrollment ID: I20170130002260

Medical Identifiers

Medical identifiers for Mrs Kristine Ericksen-miller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174079115	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	95004881 (California)	Secondary
363LP2300X	Nurse Practitioner - Primary Care	95004881 (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. Mrs Kristine Ericksen-miller allows following entities to bill medicare on her behalf.

Entity Name	Desert Medical Group Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114918612 PECOS PAC ID: 8123930427 Enrollment ID: O20031229000246

Entity Name	Minuteclinic Diagnostic Medical Group Of San Diego Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1568659233 PECOS PAC ID: 2567520414 Enrollment ID: O20090127000249

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 Kristine Ericksen-miller 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 Kristine Ericksen-miller, NP 11921 Carmel Creek Rd Apt 129, San Diego, CA 92130-2585 Ph: (310) 245-6503	Mrs Kristine Ericksen-miller, NP 4321 Birch St Ste 100, Newport Beach, CA 92660-1940 Ph: (310) 245-6503

Reviews and Comments

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Mrs Kristine Ericksen-miller, NP - Medicare Nurse Practitioner in Newport Beach, CA