Mrs Stacy Lyn Commodore, CRNA in Morgantown, WV - Medicare Nurse Anesthetist, Certified Registered

Mrs Stacy Lyn Commodore, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Morgantown, West Virginia. Her current practice location is 2000 Mon Health Medical Park Dr Ste 2001, Morgantown, West Virginia. You can reach out to her office (for appointments etc.) via phone at (304) 720-8816.

Mrs Stacy Lyn Commodore is licensed to practice in West Virginia (license number 62855) 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 1639409824.

Contact Information

	Mrs Stacy Lyn Commodore, CRNA
	2000 Mon Health Medical Park Dr Ste 2001, Morgantown, WV 26505-1167
	(304) 720-8816
	(904) 494-6467

Map and Direction

Provider's Profile

Full Name	Mrs Stacy Lyn Commodore
Gender	Female
Speciality	Nurse Anesthetist, Certified Registered
Location	2000 Mon Health Medical Park Dr Ste 2001, Morgantown, West Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1639409824
Provider Enumeration Date: 01/11/2010
Last Update Date: 03/01/2022

Medicare PECOS Information:

PECOS PAC ID: 6709913122
Enrollment ID: I20100416000135

Medical Identifiers

Medical identifiers for Mrs Stacy Lyn Commodore such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1639409824	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
367500000X	Nurse Anesthetist, Certified Registered	62855 (West Virginia)	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 Stacy Lyn Commodore allows following entities to bill medicare on her behalf.

Entity Name	Mid-atlantic Anesthesia Consultants Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1144248907 PECOS PAC ID: 1951205996 Enrollment ID: O20031121000450

Entity Name	United Hospital Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760965586 PECOS PAC ID: 8123936010 Enrollment ID: O20031212000802

Entity Name	Regional Eye Associates Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1336212075 PECOS PAC ID: 1456255876 Enrollment ID: O20040211001115

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 Stacy Lyn Commodore 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 Stacy Lyn Commodore, CRNA Po Box 3466, Charleston, WV 25334-3466 Ph: (304) 720-8816	Mrs Stacy Lyn Commodore, CRNA 2000 Mon Health Medical Park Dr Ste 2001, Morgantown, WV 26505-1167 Ph: (304) 720-8816

Reviews and Comments

Nurse Anesthetist, Certified Registered Nurses in Morgantown, WV

Tanya C Ammons, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Stadium Drive, Morgantown, WV 26506 Phone: 304-598-4800 Fax: 304-285-7126
Jillann M Balko, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Center Dr, Morgantown, WV 26506 Phone: 304-598-4122
Taylor Elizabeth Spinosi, Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Center Dr, Morgantown, WV 26506 Phone: 304-598-4000
David R Johnson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Center Dr, Morgantown, WV 26506 Phone: 304-598-4000
Lori A Rizor, CRNA Nurse Anesthetist - CR Medicare: Medicare Enrolled Practice Location: 1200 J D Anderson Dr, Monongalia Genral Hospital, Morgantown, WV 26505 Phone: 304-285-1245 Fax: 304-285-2131
Walter J Kielkowski, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 101 Stadium Dr, Morgantown, WV 26506 Phone: 304-598-4000 Fax: 304-293-6963
Amanda Renee Larew, CRNA, APRN Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 2 French Quarters Dr, Morgantown, WV 26505 Phone: 304-376-7635

Mrs Stacy Lyn Commodore, CRNA - Medicare Nurse Anesthetist, Certified Registered in Morgantown, WV