Nicole Kindness Mortensen, CNM, WHNP is a medicare enrolled "Advanced Practice Midwife" in Safford, Arizona. Her current practice location is
2020 W 16th St, Safford, Arizona. You can reach out to her office (for appointments etc.) via phone at
(928) 424-4444.
Nicole Kindness Mortensen is licensed to practice in Arizona (license number AP9562) 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 1962953497.
Provider's Profile
| Full Name | Nicole Kindness Mortensen |
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| Gender | Female |
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| Speciality | Advanced Practice Midwife |
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| Location | 2020 W 16th St, Safford, Arizona |
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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: 1962953497
- Provider Enumeration Date: 10/19/2016
- Last Update Date: 12/01/2016
Medicare PECOS Information:
- PECOS PAC ID: 3072894468
- Enrollment ID: I20161222001190
Medical Identifiers
Medical identifiers for Nicole Kindness Mortensen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962953497 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LW0102X | Nurse Practitioner - Women's Health | AP9568 (Arizona) | Secondary |
| 367A00000X | Advanced Practice Midwife | AP9562 (Arizona) | 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. Nicole Kindness Mortensen allows following entities to bill medicare on her behalf.
| Entity Name | Mt Graham Regional Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275588345
PECOS PAC ID: 6204822364
Enrollment ID: O20040423000105 |
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| Entity Name | Mt Graham Regional Medical Center Inc |
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| Entity Type | Part A Provider - Critical Access Hospital |
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| Entity Identifiers | NPI Number: 1275588345
PECOS PAC ID: 6204822364
Enrollment ID: O20201016000847 |
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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. Nicole Kindness Mortensen 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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Nicole Kindness Mortensen, CNM, WHNP
2020 W 16th St,
Safford, AZ 85546-4026
Ph: (928) 424-4444 | Nicole Kindness Mortensen, CNM, WHNP
2020 W 16th St,
Safford, AZ 85546-4026
Ph: (928) 424-4444 |
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