Theresa Bourg Vicknair, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lutcher, Louisiana. She graduated from nursing school in 1987 and has 37 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Zephyr Anesthesia Llc and her current practice location is
St James Parish Hosipital, Louisiane Ave, Lutcher, Louisiana. You can reach out to her office (for appointments etc.) via phone at
(225) 869-5512.
Theresa Bourg Vicknair is licensed to practice in Louisiana (license number AP01519) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1134100746.
Provider's Profile
Full Name | Theresa Bourg Vicknair |
---|
Gender | Female |
---|
Speciality | Certified Registered Nurse Anesthetist (crna) |
---|
Experience | 37 Years |
---|
Location | St James Parish Hosipital, Lutcher, Louisiana |
---|
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Theresa Bourg Vicknair graduated from nursing school in 1987
NPI Data:
- NPI Number: 1134100746
- Provider Enumeration Date: 11/10/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 2163614751
- Enrollment ID: I20101014000905
Medical Identifiers
Medical identifiers for Theresa Bourg Vicknair such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1134100746 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
163W00000X | Registered Nurse | RN059871 (Louisiana) | Primary |
367500000X | Nurse Anesthetist, Certified Registered | AP01519 (Louisiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Zephyr Anesthesia Llc | 1658559125 | 75 |
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. Theresa Bourg Vicknair allows following entities to bill medicare on her behalf.
Entity Name | Childrens Hospital Anesthesia Corporation |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1649362740 PECOS PAC ID: 0446152862 Enrollment ID: O20040124000258 |
---|
Entity Name | Physicians Medical Center, Llc |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1477509859 PECOS PAC ID: 2062308364 Enrollment ID: O20040224000911 |
---|
Entity Name | Zephyr Anesthesia Llc |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1891087458 PECOS PAC ID: 1658559125 Enrollment ID: O20110705000180 |
---|
Entity Name | Hola Anesthesia Llc |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1023598067 PECOS PAC ID: 3476891789 Enrollment ID: O20190212002247 |
---|
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. Theresa Bourg Vicknair 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 |
Theresa Bourg Vicknair, CRNA 124 Jennifer Ln, La Place, LA 70068-5806 Ph: (985) 359-0599 | Theresa Bourg Vicknair, CRNA St James Parish Hosipital, Louisiane Ave, Lutcher, LA 70071 Ph: (225) 869-5512 |
Reviews and Comments