Alicia-maria Fernandez, DO is a medicare enrolled "Internal Medicine" physician in Friendship, Wisconsin. Her current practice location is
402 W Lake St, Friendship, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(608) 339-3331.
Alicia-maria Fernandez is licensed to practice in Wisconsin (license number 50947) 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 1407043458.
Physician's Profile
| Full Name | Alicia-maria Fernandez |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Location | 402 W Lake St, Friendship, 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: 1407043458
- Provider Enumeration Date: 10/03/2007
- Last Update Date: 07/21/2022
Medicare PECOS Information:
- PECOS PAC ID: 2163518242
- Enrollment ID: I20140909002560
Medical Identifiers
Medical identifiers for Alicia-maria Fernandez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1407043458 | NPI | - | NPPES |
| K400386662 | Other | WI | MEDICARE PIN |
| 43545200 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208000000X | Pediatrics | 50947 (Wisconsin) | Secondary |
| 207R00000X | Internal Medicine | 50947 (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. Alicia-maria Fernandez allows following entities to bill medicare on her behalf.
| Entity Name | Moundview Memorial Hospital & Clinics Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1710939533
PECOS PAC ID: 1355250432
Enrollment ID: O20031121000846 |
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| Entity Name | Mile Bluff Medical Center Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1609912005
PECOS PAC ID: 8527971399
Enrollment ID: O20031205000618 |
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| Entity Name | Primary Connection Health Care, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457370744
PECOS PAC ID: 3870577935
Enrollment ID: O20040616000370 |
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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. Alicia-maria Fernandez 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 |
|---|
Alicia-maria Fernandez, DO
402 W Lake St,
Friendship, WI 53934-9699
Ph: (608) 339-3331 | Alicia-maria Fernandez, DO
402 W Lake St,
Friendship, WI 53934-9699
Ph: (608) 339-3331 |
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