Dr Mauricio Wiltz, DDS is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Bronx, New York. His current practice location is
3332 Rochambeau Avenue, Department Of Dentistry, 2nd Floor, Bronx, New York. You can reach out to his office (for appointments etc.) via phone at
(718) 920-4984.
Dr Mauricio Wiltz is licensed to practice in New York (license number 043995) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1760485247.
Healthcare Provider's Profile
| Full Name | Dr Mauricio Wiltz |
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| Gender | Male |
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| Speciality | Oral & Maxillofacial Surgery |
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| Location | 3332 Rochambeau Avenue, Bronx, New York |
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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: 1760485247
- Provider Enumeration Date: 05/27/2005
- Last Update Date: 11/26/2019
Medicare PECOS Information:
- PECOS PAC ID: 7315990967
- Enrollment ID: I20050223000952
Medical Identifiers
Medical identifiers for Dr Mauricio Wiltz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760485247 | NPI | - | NPPES |
| 01763744 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 043995 (New York) | Secondary |
| 204E00000X | Oral & Maxillofacial Surgery | 043995 (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. Dr Mauricio Wiltz allows following entities to bill medicare on his behalf.
| Entity Name | Montefiore Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275710519
PECOS PAC ID: 3779496021
Enrollment ID: O20121113000371 |
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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. Dr Mauricio Wiltz 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 |
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Dr Mauricio Wiltz, DDS
36 Halstead Ave,
Yonkers, NY 10704-3008
Ph: (914) 237-9094 | Dr Mauricio Wiltz, DDS
3332 Rochambeau Avenue, Department Of Dentistry, 2nd Floor,
Bronx, NY 10467-2836
Ph: (718) 920-4984 |
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