Ms Mimi Sue Smith-danielson, ARNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Kingston, Washington. Her current practice location is
26788 Highland Rd Ne, Kingston, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 297-8876.
Ms Mimi Sue Smith-danielson is licensed to practice in Washington (license number AP30001519) 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 1174533202.
Provider's Profile
| Full Name | Ms Mimi Sue Smith-danielson |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Gerontology |
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| Location | 26788 Highland Rd Ne, Kingston, Washington |
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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: 1174533202
- Provider Enumeration Date: 08/09/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 7315978921
- Enrollment ID: I20050823001196
Medical Identifiers
Medical identifiers for Ms Mimi Sue Smith-danielson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1174533202 | NPI | - | NPPES |
| 2813SM | Other | | REGENCE |
| 9633819 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | RN00039969 (Washington) | Primary |
| 363LG0600X | Nurse Practitioner - Gerontology | AP30001519 (Washington) | 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. Ms Mimi Sue Smith-danielson allows following entities to bill medicare on her behalf.
| Entity Name | Franciscan Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093165334
PECOS PAC ID: 0547173866
Enrollment ID: O20031111000789 |
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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. Ms Mimi Sue Smith-danielson 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 |
|---|
Ms Mimi Sue Smith-danielson, ARNP
26788 Highland Rd Ne,
Kingston, WA 98346
Ph: (360) 297-8876 | Ms Mimi Sue Smith-danielson, ARNP
26788 Highland Rd Ne,
Kingston, WA 98346
Ph: (360) 297-8876 |
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