Mrs Tori Raye Hazel, AGCNS-BC is a medicare enrolled "Clinical Nurse Specialist - Gerontology" in Altus, Oklahoma. Her current practice location is
1200 E Broadway St, Altus, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(580) 379-6000.
Mrs Tori Raye Hazel is licensed to practice in Oklahoma (license number 204080) 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 1578134979.
Provider's Profile
| Full Name | Mrs Tori Raye Hazel |
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| Gender | Female |
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| Speciality | Clinical Nurse Specialist - Gerontology |
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| Location | 1200 E Broadway St, Altus, Oklahoma |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1578134979
- Provider Enumeration Date: 07/07/2021
- Last Update Date: 07/07/2021
Medicare PECOS Information:
- PECOS PAC ID: 9830573427
- Enrollment ID: I20220831000993
Medical Identifiers
Medical identifiers for Mrs Tori Raye Hazel such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1578134979 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 364SG0600X | Clinical Nurse Specialist - Gerontology | 204080 (Oklahoma) | 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 Tori Raye Hazel allows following entities to bill medicare on her behalf.
| Entity Name | Cancer Centers Of Southwest Oklahoma, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073787792
PECOS PAC ID: 7810065323
Enrollment ID: O20100308000391 |
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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 Tori Raye Hazel 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 Tori Raye Hazel, AGCNS-BC
1104 Ruth Rd,
Altus, OK 73521-1236
Ph: (580) 471-8171 | Mrs Tori Raye Hazel, AGCNS-BC
1200 E Broadway St,
Altus, OK 73521-5702
Ph: (580) 379-6000 |
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