Susan Jane Evitts, CRNP is a medicare enrolled "Nurse Practitioner" in Lykens, Pennsylvania. Her current practice location is
517 South St, Lykens, Pennsylvania. You can reach out to her office (for appointments etc.) via phone at
(717) 453-1073.
Susan Jane Evitts is licensed to practice in Pennsylvania (license number SP026492) 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 1427042241.
Provider's Profile
| Full Name | Susan Jane Evitts |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Location | 517 South St, Lykens, Pennsylvania |
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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: 1427042241
- Provider Enumeration Date: 09/08/2005
- Last Update Date: 03/30/2023
Medicare PECOS Information:
- PECOS PAC ID: 3476780156
- Enrollment ID: I20131231000118
Medical Identifiers
Medical identifiers for Susan Jane Evitts such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1427042241 | NPI | - | NPPES |
| 1031413460002 | Medicaid | PA | |
| 2M3648 | Other | PA | MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | RN266659L (Pennsylvania) | Secondary |
| 363LP0200X | Nurse Practitioner - Pediatrics | UP006785D (Pennsylvania) | Secondary |
| 363L00000X | Nurse Practitioner | SP026492 (Pennsylvania) | 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. Susan Jane Evitts allows following entities to bill medicare on her behalf.
| Entity Name | Family Practice Center Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154376937
PECOS PAC ID: 0244124212
Enrollment ID: O20040211000012 |
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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. Susan Jane Evitts 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 |
|---|
Susan Jane Evitts, CRNP
7 Dock Hill Rd,
Middleburg, PA 17842-8910
Ph: (570) 837-2123 | Susan Jane Evitts, CRNP
517 South St,
Lykens, PA 17048-1520
Ph: (717) 453-1073 |
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