Ellie Heydari, DDS is a medicare enrolled "Dentist - General Practice" provider in Bayfield, Wisconsin. Her current practice location is
36745 Aiken Rd., Red Cliff Community Health Center, Bayfield, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(715) 779-3707.
Ellie Heydari is licensed to practice in Wisconsin (license number 7252-15) 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 1518137652.
Healthcare Provider's Profile
| Full Name | Ellie Heydari |
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| Gender | Female |
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| Speciality | Dentist - General Practice |
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| Location | 36745 Aiken Rd., Bayfield, Wisconsin |
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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: 1518137652
- Provider Enumeration Date: 03/05/2008
- Last Update Date: 02/10/2017
Medicare PECOS Information:
- PECOS PAC ID: 5991001653
- Enrollment ID: I20231219003974
Medical Identifiers
Medical identifiers for Ellie Heydari such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1518137652 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 1223G0001X | Dentist - General Practice | 2901017468 (Michigan) | Secondary |
| 1223G0001X | Dentist - General Practice | 7252-15 (Wisconsin) | 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. Ellie Heydari allows following entities to bill medicare on her behalf.
| Entity Name | Department Of Health & Human Services Phs Ihs |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194754382
PECOS PAC ID: 7517879794
Enrollment ID: O20031105000353 |
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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. Ellie Heydari 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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Ellie Heydari, DDS
36745 Aiken Rd, 36745 Aiken Rd.,
Bayfield, WI 54814-4579
Ph: (715) 779-3707 | Ellie Heydari, DDS
36745 Aiken Rd., Red Cliff Community Health Center,
Bayfield, WI 54814
Ph: (715) 779-3707 |
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