Mrs Laura Pavel Ketelsen, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Port Jefferson Station, New York. She graduated from nursing school in 2019 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Parviz Soomekh, Md Pc and her current practice location is
5316 Nesconset Hwy, Port Jefferson Station, New York. You can reach out to her office (for appointments etc.) via phone at
(833) 660-7246.
Mrs Laura Pavel Ketelsen is licensed to practice in Florida (license number 128906) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1578194247.
Provider's Profile
| Full Name | Mrs Laura Pavel Ketelsen |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 5 Years |
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| Location | 5316 Nesconset Hwy, Port Jefferson Station, New York |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Mrs Laura Pavel Ketelsen graduated from nursing school in 2019
NPI Data:
- NPI Number: 1578194247
- Provider Enumeration Date: 01/30/2020
- Last Update Date: 09/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 4486083037
- Enrollment ID: I20230818001751
Medical Identifiers
Medical identifiers for Mrs Laura Pavel Ketelsen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1578194247 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 128906 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Parviz Soomekh, Md Pc | 9739464660 | 2 |
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 Laura Pavel Ketelsen allows following entities to bill medicare on her behalf.
| Entity Name | Parviz Soomekh, Md Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790142677
PECOS PAC ID: 9739464660
Enrollment ID: O20170316000247 |
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| Entity Name | Quality Medical Management Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114502606
PECOS PAC ID: 5799193074
Enrollment ID: O20210427000857 |
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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 Laura Pavel Ketelsen 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 |
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Mrs Laura Pavel Ketelsen, CRNA
10 Shenandoah Blvd,
Port Jefferson Station, NY 11776-2022
Ph: (703) 314-4055 | Mrs Laura Pavel Ketelsen, CRNA
5316 Nesconset Hwy,
Port Jefferson Station, NY 11776-2591
Ph: (833) 660-7246 |
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