Nicolette Carly Hansen, APRN, BSN, RN in Salt Lake City, UT

Nicolette Carly Hansen, APRN, BSN, RN is a medicare enrolled "Nurse Practitioner - Neonatal" in Salt Lake City, Utah. Her current practice location is 50 N Medical Dr Bldg 525, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 581-2098.

Nicolette Carly Hansen is licensed to practice in Washington (license number AP61252148) 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 1033698832.

Contact Information

	Nicolette Carly Hansen, APRN, BSN, RN
	50 N Medical Dr Bldg 525, Salt Lake City, UT 84132-0001
	(801) 581-2098
	Not Available

Map and Direction

Provider's Profile

Full Name	Nicolette Carly Hansen
Gender	Female
Speciality	Nurse Practitioner - Neonatal
Location	50 N Medical Dr Bldg 525, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1033698832
Provider Enumeration Date: 08/13/2018
Last Update Date: 03/04/2022

Medicare PECOS Information:

PECOS PAC ID: 9335534064
Enrollment ID: I20220316002647

Medical Identifiers

Medical identifiers for Nicolette Carly Hansen such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1033698832	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LN0000X	Nurse Practitioner - Neonatal	AP61252148 (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. Nicolette Carly Hansen allows following entities to bill medicare on her behalf.

Entity Name	The Association Of University Physicians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023041159 PECOS PAC ID: 0446162697 Enrollment ID: O20031105000244

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. Nicolette Carly Hansen 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
Nicolette Carly Hansen, APRN, BSN, RN 30 L St, Salt Lake City, UT 84103-3458 Ph: (801) 870-3070	Nicolette Carly Hansen, APRN, BSN, RN 50 N Medical Dr Bldg 525, Salt Lake City, UT 84132-0001 Ph: (801) 581-2098

Reviews and Comments

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Nicolette Carly Hansen, APRN, BSN, RN - Medicare Nurse Practitioner in Salt Lake City, UT