Alicia Marie Wilson, DO in South Bend, IN

Alicia Marie Wilson, DO is a medicare enrolled "Pediatrics" physician in South Bend, Indiana. Her current practice location is 211 N Eddy St, South Bend, Indiana. You can reach out to her office (for appointments etc.) via phone at (574) 233-7337.

Alicia Marie Wilson is licensed to practice in Indiana (license number 02004821A) 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 1285070284.

Contact Information

	Alicia Marie Wilson, DO
	211 N Eddy St, South Bend, IN 46617-3096
	(574) 233-7337
	(574) 239-1561

Map and Direction

Physician's Profile

Full Name	Alicia Marie Wilson
Gender	Female
Speciality	Pediatrics
Location	211 N Eddy St, South Bend, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1285070284
Provider Enumeration Date: 05/16/2013
Last Update Date: 06/27/2016

Medicare PECOS Information:

PECOS PAC ID: 8325330780
Enrollment ID: I20160706001242

Medical Identifiers

Medical identifiers for Alicia Marie Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1285070284	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	02004821A (Indiana)	Primary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary

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 Marie Wilson allows following entities to bill medicare on her behalf.

Entity Name	The South Bend Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073680419 PECOS PAC ID: 3779577937 Enrollment ID: O20040412000439

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 Marie Wilson 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 Marie Wilson, DO 211 N Eddy St, South Bend, IN 46617-3096 Ph: (574) 233-7337	Alicia Marie Wilson, DO 211 N Eddy St, South Bend, IN 46617-3096 Ph: (574) 233-7337

Reviews and Comments

Pediatrics Doctors in South Bend, IN

Angela C Herman, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 615 N Michigan St, 4th Fl, South Bend, IN 46601 Phone: 574-647-6892 Fax: 574-647-6895
Asad Ansari, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 100 Navarre Pl Ste 5550, South Bend, IN 46601 Phone: 574-647-2550 Fax: 574-647-1129
Megan Elizabeth Conway, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 615 N Michigan St, 5th Fl, South Bend, IN 46601 Phone: 574-647-7275 Fax: 574-647-3696
Dr. Lori A Wykoff, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 415 E Madison St, South Bend, IN 46617 Phone: 574-533-1234 Fax: 574-537-2652
Ruchita Kachru, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1815 E Ireland Rd, South Bend, IN 46614 Phone: 574-647-1700 Fax: 574-291-3351
Dr. Robert Dennis White, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 615 N Michigan St, South Bend, IN 46601 Phone: 574-647-7351 Fax: 574-647-7248
Hari Rasad Gourabathini, M.D Pediatrics Medicare: Medicare Enrolled Practice Location: 615 N Michigan St 5th Fl, South Bend, IN 46601 Phone: 574-647-7275 Fax: 574-647-3696

Alicia Marie Wilson, DO - Medicare Pediatrics in South Bend, IN