Mrs Jennifer Elaine Nydam, RN, CNM - Medicare Advanced Practice Midwife in Ft Defiance, AZ

Mrs Jennifer Elaine Nydam, RN, CNM is a medicare enrolled "Advanced Practice Midwife" in Ft Defiance, Arizona. Her current practice location is Corner Of Route N12 And N7, Ft Defiance, Arizona. You can reach out to her office (for appointments etc.) via phone at (928) 729-8000.

Mrs Jennifer Elaine Nydam is licensed to practice in New Mexico (license number 773) 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 1407958432.

Contact Information

Mrs Jennifer Elaine Nydam, RN, CNM
Corner Of Route N12 And N7,
Ft Defiance, AZ 86504-0649
(928) 729-8000
Not Available



Provider's Profile

Full NameMrs Jennifer Elaine Nydam
GenderFemale
SpecialityAdvanced Practice Midwife
LocationCorner Of Route N12 And N7, Ft Defiance, Arizona
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1407958432
  • Provider Enumeration Date: 09/01/2006
  • Last Update Date: 10/16/2019
  Medicare PECOS Information:
  • PECOS PAC ID: 5698921484
  • Enrollment ID: I20120810000061

Medical Identifiers

Medical identifiers for Mrs Jennifer Elaine Nydam such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1407958432NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367A00000XAdvanced Practice Midwife 1683 (California)Secondary
367A00000XAdvanced Practice Midwife 773 (New Mexico)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. Mrs Jennifer Elaine Nydam allows following entities to bill medicare on her behalf.
Entity NameThe Fort Defiance Indian Hospital Board, Incorporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477876639
PECOS PAC ID: 0941336697
Enrollment ID: O20100429001153

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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. Mrs Jennifer Elaine Nydam 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
Mrs Jennifer Elaine Nydam, RN, CNM
808 E Green Ave,
Gallup, NM 87301-5513

Ph: (707) 367-1977
Mrs Jennifer Elaine Nydam, RN, CNM
Corner Of Route N12 And N7,
Ft Defiance, AZ 86504-0649

Ph: (928) 729-8000

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Advanced Practice Midwife Nurses in Ft Defiance, AZ


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