Benjamin Genesis M Bautista Ii, MD in Oshkosh, WI

Benjamin Genesis M Bautista Ii, MD is a medicare enrolled "Emergency Medicine" physician in Oshkosh, Wisconsin. His current practice location is 855 N Westhaven Dr, Oshkosh, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 456-7400.

Benjamin Genesis M Bautista Ii is licensed to practice in Illinois (license number 036130758) 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 1396051561.

Contact Information

	Benjamin Genesis M Bautista Ii, MD
	855 N Westhaven Dr, Oshkosh, WI 54904-7668
	(920) 456-7400
	Not Available

Map and Direction

Physician's Profile

Full Name	Benjamin Genesis M Bautista Ii
Gender	Male
Speciality	Emergency Medicine
Location	855 N Westhaven Dr, Oshkosh, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1396051561
Provider Enumeration Date: 08/26/2010
Last Update Date: 07/10/2017

Medicare PECOS Information:

PECOS PAC ID: 5597954735
Enrollment ID: I20110104000950

Medical Identifiers

Medical identifiers for Benjamin Genesis M Bautista Ii such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1396051561	NPI	-	NPPES
036130758	Other	IL	IL STATE LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	54794 (Wisconsin)	Secondary
207P00000X	Emergency Medicine	036130758 (Illinois)	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. Benjamin Genesis M Bautista Ii allows following entities to bill medicare on his behalf.

Entity Name	Froedtert Manitowoc Medical Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437829975 PECOS PAC ID: 2365836954 Enrollment ID: O20220224001282

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. Benjamin Genesis M Bautista Ii 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
Benjamin Genesis M Bautista Ii, MD 2100 S. Marshall Blvd., Apt 805, Chicago, IL 60623 Ph: (920) 750-3060	Benjamin Genesis M Bautista Ii, MD 855 N Westhaven Dr, Oshkosh, WI 54904-7668 Ph: (920) 456-7400

Reviews and Comments

Emergency Medicine Doctors in Oshkosh, WI

John M Rosebush Jr., MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-456-7400 Fax: 920-456-7421
Kevin L Polglaze, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-490-9046
Hannah Johnshoy, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700
Trevor C Fenrich, EMT-B Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 621 Evans St, Oshkosh, WI 54901 Phone: 920-233-0888
Jayzon P Martonito, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-303-8700
Daniel Gale, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 855 N Westhaven Dr, Oshkosh, WI 54904 Phone: 920-456-7400 Fax: 920-456-7421

Benjamin Genesis M Bautista Ii, MD - Medicare Emergency Medicine in Oshkosh, WI