Stacyann M Evans, is a medicare enrolled "Nurse Practitioner - Family" in Copiague, New York. Her current practice location is
160 Beachview St, Copiague, New York. You can reach out to her office (for appointments etc.) via phone at
(631) 464-1497.
Stacyann M Evans is licensed to practice in New York (license number F353349-01) 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 1295593663.
Provider's Profile
| Full Name | Stacyann M Evans |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Family |
|---|
| Location | 160 Beachview St, Copiague, New York |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1295593663
- Provider Enumeration Date: 03/11/2024
- Last Update Date: 03/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 8820538705
- Enrollment ID: I20240905004181
Medical Identifiers
Medical identifiers for Stacyann M Evans such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295593663 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363LF0000X | Nurse Practitioner - Family | F353349-01 (New York) | 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. Stacyann M Evans allows following entities to bill medicare on her behalf.
| Entity Name | Mill Basin Medical Health Pc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1346006202
PECOS PAC ID: 9133566128
Enrollment ID: O20240326003311 |
|---|
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. Stacyann M Evans 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 |
|---|
Stacyann M Evans,
160 Beachview St,
Copiague, NY 11726-3602
Ph: (631) 464-1497 | Stacyann M Evans,
160 Beachview St,
Copiague, NY 11726-3602
Ph: (631) 464-1497 |
Reviews and Comments