We have a local skilled nursing facility asking if we can see patients there when needed for routine type care, i.e. impacted cerumen. The docs asked if an RN could perform this. My response was I believe an NP or PA could possibly perform this but not an RN. Also would an NP or PA be able to see these patients without the physician seeing them for the first time. Also would the NP or PA be billing Medicare under their own ID number or under the physicians ID. These patients would be mostly Medicare patients.