Shazam Bacchus, APN in Newark, NJ - Medicare Nurse Practitioner

Shazam Bacchus, APN is a medicare enrolled "Nurse Practitioner - Primary Care" in Newark, New Jersey. His current practice location is 459 N 7th St Fl 1, Newark, New Jersey. You can reach out to his office (for appointments etc.) via phone at (973) 388-9560.

Shazam Bacchus is licensed to practice in New Jersey (license number 26NJ01004000) 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 1972133254.

Contact Information

	Shazam Bacchus, APN
	459 N 7th St Fl 1, Newark, NJ 07107-3743
	(973) 388-9560
	Not Available

Map and Direction

Provider's Profile

Full Name	Shazam Bacchus
Gender	Male
Speciality	Nurse Practitioner - Primary Care
Location	459 N 7th St Fl 1, Newark, New Jersey
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1972133254
Provider Enumeration Date: 01/24/2020
Last Update Date: 01/24/2020

Medicare PECOS Information:

PECOS PAC ID: 1153700414
Enrollment ID: I20220617000122

Medical Identifiers

Medical identifiers for Shazam Bacchus such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1972133254	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LP2300X	Nurse Practitioner - Primary Care	26NJ01004000 (New Jersey)	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. Shazam Bacchus allows following entities to bill medicare on his behalf.

Entity Name	University Hospital
Entity Type	Part B Supplier - Hospital Department(s)
Entity Identifiers	NPI Number: 1023266962 PECOS PAC ID: 5294636874 Enrollment ID: O20081004000043

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. Shazam Bacchus 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
Shazam Bacchus, APN 459 N 7th St Fl 1, Newark, NJ 07107-3743 Ph: (973) 388-9560	Shazam Bacchus, APN 459 N 7th St Fl 1, Newark, NJ 07107-3743 Ph: (973) 388-9560

Reviews and Comments

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Shazam Bacchus, APN - Medicare Nurse Practitioner in Newark, NJ