Phillip Conwell Jr, CRNA - Medicare Registered Nurse in Fort Bragg, CA

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Phillip Conwell Jr, CRNA is a medicare enrolled "Registered Nurse" in Fort Bragg, California. His current practice location is 700 River Dr, Fort Bragg, California. You can reach out to his office (for appointments etc.) via phone at (707) 961-1234.

Phillip Conwell Jr is licensed to practice in California (license number RN405621) 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 1255540340.

Contact Information

Phillip Conwell Jr, CRNA
700 River Dr,
Fort Bragg, CA 95437-5403
(707) 961-1234
Not Available

Map and Direction




Provider's Profile

Full NamePhillip Conwell Jr
GenderMale
SpecialityRegistered Nurse
Location700 River Dr, Fort Bragg, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1255540340
  • Provider Enumeration Date: 05/22/2007
  • Last Update Date: 03/18/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4789625898
  • Enrollment ID: I20050519000177

Medical Identifiers

Medical identifiers for Phillip Conwell Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255540340NPI-NPPES
1064OtherCACALIFORNIA BOARD OF REGISTERED NURSING

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse RN405621 (California)Primary
367500000XNurse Anesthetist, Certified Registered 1064 (California)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. Phillip Conwell Jr allows following entities to bill medicare on his behalf.
Entity NameJohn A Kermen
Entity TypePractitioner - Anesthesiology
Entity IdentifiersNPI Number: 1306896428
PECOS PAC ID: 4385670629
Enrollment ID: I20050708000779
Entity NameProgressive Anesthesia Consultants Of California
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558925610
PECOS PAC ID: 5395073803
Enrollment ID: O20190821004585
Entity NameAdventist Health Mendocino Coast
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1538113725
PECOS PAC ID: 3678990769
Enrollment ID: O20220620001667

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. Phillip Conwell Jr 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 AddressPractice Location Address
Phillip Conwell Jr, CRNA
Po Box 937,
Mendocino, CA 95460-0937

Ph: (707) 813-7639		Phillip Conwell Jr, CRNA
700 River Dr,
Fort Bragg, CA 95437-5403

Ph: (707) 961-1234

Reviews and Comments


Registered Nurse Nurses in Fort Bragg, CA

Maureen Smyth,
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 1025 E Chestnut St, Fort Bragg, CA 95437
Phone: 978-360-2505    
Jennifer Salyer, RN
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 855 Sequoia Cir, Fort Bragg, CA 95437
Phone: 707-964-1251    Fax: 707-961-2722
Ms. Jenna Rose Breton, NPF
Registered Nurse
Medicare: Medicare Enrolled
Practice Location: 855 Sequoia Cir, Fort Bragg, CA 95437
Phone: 707-964-1251    
John Clarendon Worthington, RN
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 516 Cypress St, Fort Bragg, CA 95437
Phone: 707-472-0350    
Breon Maree Henderson, RNC, MSN, CLC
Registered Nurse
Medicare: Not Enrolled in Medicare
Practice Location: 510 Cypress St, Ste D, Fort Bragg, CA 95437
Phone: 707-964-5696    Fax: 707-964-6274
Lisa Gay Fredrickson, FNP
Registered Nurse
Medicare: Medicare Enrolled
Practice Location: 205 South St, Fort Bragg, CA 95437
Phone: 707-961-1251    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.