Dr Alfonso E Urdaneta, MD is a medicare enrolled "Family Medicine" physician in Nashville, Illinois. He graduated from medical school in 1967 and has 57 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Washington County Hospital District and his current practice location is
705 South Grand Avenue, Nashville, Illinois. You can reach out to his office (for appointments etc.) via phone at
(618) 327-2225.
Dr Alfonso E Urdaneta is licensed to practice in Illinois (license number 036047128) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1225085590.
Physician's Profile
| Full Name | Dr Alfonso E Urdaneta |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 57 Years |
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| Location | 705 South Grand Avenue, Nashville, Illinois |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Alfonso E Urdaneta graduated from medical school in 1967
NPI Data:
- NPI Number: 1225085590
- Provider Enumeration Date: 05/30/2006
- Last Update Date: 11/03/2009
Medicare PECOS Information:
- PECOS PAC ID: 5597807909
- Enrollment ID: I20100123000041
Medical Identifiers
Medical identifiers for Dr Alfonso E Urdaneta such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1225085590 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208600000X | Surgery | 036047128 (Illinois) | Secondary |
| 207Q00000X | Family Medicine | 036047128 (Illinois) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Washington County Hospital District | 4880599844 | 12 |
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. Dr Alfonso E Urdaneta allows following entities to bill medicare on his behalf.
| Entity Name | Washington County Hospital District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659321560
PECOS PAC ID: 4880599844
Enrollment ID: O20031209000278 |
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| Entity Name | Integritas Emergency Physician Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790128817
PECOS PAC ID: 7113167446
Enrollment ID: O20130710000760 |
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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. Dr Alfonso E Urdaneta 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 |
|---|
Dr Alfonso E Urdaneta, MD
3416 Hotze Road,
Salem, IL 62881-6616
Ph: (618) 548-1185 | Dr Alfonso E Urdaneta, MD
705 South Grand Avenue,
Nashville, IL 62263-1534
Ph: (618) 327-2225 |
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