Pavel Siutsou, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Watchung, New Jersey. His current practice location is
135 Stanie Glen Rd, Watchung, New Jersey. You can reach out to his office (for appointments etc.) via phone at
(862) 754-6151.
Pavel Siutsou is licensed to practice in New Jersey (license number 26NJ14852700) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1881380491.
Provider's Profile
| Full Name | Pavel Siutsou |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 135 Stanie Glen Rd, Watchung, New Jersey |
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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: 1881380491
- Provider Enumeration Date: 04/17/2023
- Last Update Date: 07/26/2023
Medicare PECOS Information:
- PECOS PAC ID: 1254791585
- Enrollment ID: I20230719000337
Medical Identifiers
Medical identifiers for Pavel Siutsou such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1881380491 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | 26NJ14852700 (New Jersey) | Primary |
| 163W00000X | Registered Nurse | 793635-01 (New York) | Secondary |
| 163W00000X | Registered Nurse | 26NR15434100 (New Jersey) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 793635 (New York) | Secondary |
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. Pavel Siutsou allows following entities to bill medicare on his behalf.
| Entity Name | Garden State Healthcare Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700014545
PECOS PAC ID: 8426190687
Enrollment ID: O20100126000693 |
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| Entity Name | Parkway Anesthesia Associates Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518319755
PECOS PAC ID: 2567758931
Enrollment ID: O20160912000258 |
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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. Pavel Siutsou 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 |
|---|
Pavel Siutsou, CRNA
135 Stanie Glen Rd,
Watchung, NJ 07069-6235
Ph: (862) 754-6151 | Pavel Siutsou, CRNA
135 Stanie Glen Rd,
Watchung, NJ 07069-6235
Ph: (862) 754-6151 |
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