Brannon Elizabeth Wiedemann, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in New Orleans, Louisiana. Her current practice location is
1542 Tulane Ave, New Orleans, Louisiana. You can reach out to her office (for appointments etc.) via phone at
(504) 568-6004.
Brannon Elizabeth Wiedemann is licensed to practice in * (Not Available) (license number ) 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 1689916462.
Physician's Profile
Full Name | Brannon Elizabeth Wiedemann |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 1542 Tulane Ave, New Orleans, Louisiana |
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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: 1689916462
- Provider Enumeration Date: 03/20/2013
- Last Update Date: 05/08/2018
Medicare PECOS Information:
- PECOS PAC ID: 7315240546
- Enrollment ID: I20180223001116
Medical Identifiers
Medical identifiers for Brannon Elizabeth Wiedemann such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1689916462 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2084P0800X | Psychiatry & Neurology - Psychiatry | MD.207587 (Louisiana) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Brannon Elizabeth Wiedemann allows following entities to bill medicare on her behalf.
Entity Name | Administrators Of The Tulane Educational Fund |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1528014164 PECOS PAC ID: 0446163760 Enrollment ID: O20031201000636 |
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Entity Name | East Louisiana State Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1043206543 PECOS PAC ID: 6002853835 Enrollment ID: O20050413000902 |
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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. Brannon Elizabeth Wiedemann 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 |
Brannon Elizabeth Wiedemann, MD 2028 Camp St, New Orleans, LA 70130-5032 Ph: (985) 630-8838 | Brannon Elizabeth Wiedemann, MD 1542 Tulane Ave, New Orleans, LA 70112-2865 Ph: (504) 568-6004 |
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