Randall Mark Wilk, MD DDS PHD is a medicare enrolled "Oral & Maxillofacial Surgery" provider in Gretna, Louisiana. His current practice location is
120 Meadowcrest St., Suite 300, Gretna, Louisiana. You can reach out to his office (for appointments etc.) via phone at
(504) 362-6135.
Randall Mark Wilk is licensed to practice in Louisiana (license number 022962) 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 1669578944.
Healthcare Provider's Profile
Full Name | Randall Mark Wilk |
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Gender | Male |
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Speciality | Oral & Maxillofacial Surgery |
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Location | 120 Meadowcrest St., Gretna, Louisiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1669578944
- Provider Enumeration Date: 09/15/2006
- Last Update Date: 04/22/2013
Medicare PECOS Information:
- PECOS PAC ID: 0749295632
- Enrollment ID: I20060214000423
Medical Identifiers
Medical identifiers for Randall Mark Wilk such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1669578944 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4669 (Louisiana) | Secondary |
204E00000X | Oral & Maxillofacial Surgery | 022962 (Louisiana) | 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. Randall Mark Wilk allows following entities to bill medicare on his behalf.
Entity Name | Randall M Wilk Md Dds Phd Apmc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1285849166 PECOS PAC ID: 2264530625 Enrollment ID: O20070607000630 |
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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. Randall Mark Wilk 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 |
Randall Mark Wilk, MD DDS PHD 120 Meadowcrest St., Suite 300, Gretna, LA 70056 Ph: (504) 362-6135 | Randall Mark Wilk, MD DDS PHD 120 Meadowcrest St., Suite 300, Gretna, LA 70056 Ph: (504) 362-6135 |
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