Mary Mcdaniel, MD is a medicare enrolled "Dermatology" provider in De Pere, Wisconsin. Her current practice location is
1400 Scheuring Rd, De Pere, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 964-0229.
Mary Mcdaniel is licensed to practice in Wisconsin (license number 81655-20) 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 1184015984.
Healthcare Provider's Profile
Full Name | Mary Mcdaniel |
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Gender | Female |
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Speciality | Dermatology |
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Location | 1400 Scheuring Rd, De Pere, Wisconsin |
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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: 1184015984
- Provider Enumeration Date: 02/16/2015
- Last Update Date: 08/08/2023
Medicare PECOS Information:
- PECOS PAC ID: 6305172123
- Enrollment ID: I20230830001722
Medical Identifiers
Medical identifiers for Mary Mcdaniel such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1184015984 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | 7327 (Ohio) | Secondary |
207N00000X | Dermatology | 81655-20 (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. Mary Mcdaniel allows following entities to bill medicare on her behalf.
Provider Name | Forefront Dermatology Sc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1083768253 PECOS PAC ID: 3779471701 Enrollment ID: O20040310000252 |
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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. Mary Mcdaniel 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 |
Mary Mcdaniel, MD 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008 | Mary Mcdaniel, MD 1400 Scheuring Rd, De Pere, WI 54115-1067 Ph: (920) 964-0229 |
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