Austin David Promersberger, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Minneapolis, Minnesota. His current practice location is
420 Delaware Street Se, Mmc 292, Minneapolis, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(612) 626-5589.
Austin David Promersberger is licensed to practice in Minnesota (license number 33446) 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 1629707567.
Physician's Profile
Full Name | Austin David Promersberger |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 420 Delaware Street Se, Minneapolis, Minnesota |
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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: 1629707567
- Provider Enumeration Date: 06/07/2022
- Last Update Date: 04/27/2023
Medicare PECOS Information:
- PECOS PAC ID: 0749640258
- Enrollment ID: I20230715000554
Medical Identifiers
Medical identifiers for Austin David Promersberger such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1629707567 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | RL18678 (North Dakota) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | 33446 (Minnesota) | Primary |
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. Austin David Promersberger 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 |
Austin David Promersberger, 420 Delaware Street Se, Mmc 292, Minneapolis, MN 55455 Ph: (612) 626-5589 | Austin David Promersberger, 420 Delaware Street Se, Mmc 292, Minneapolis, MN 55455 Ph: (612) 626-5589 |
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