Dr Azam Ahmed Qureshi, MD in Manitowoc, WI

Dr Azam Ahmed Qureshi, MD is a medicare enrolled "Dermatology" physician in Manitowoc, Wisconsin. His current practice location is 1515 Randolph Ct, Manitowoc, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 683-5278.

Dr Azam Ahmed Qureshi is licensed to practice in Wisconsin (license number 100818-875) 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 1245899038.

Contact Information

	Dr Azam Ahmed Qureshi, MD
	1515 Randolph Ct, Manitowoc, WI 54220-8345
	(920) 683-5278
	(920) 482-0359

Map and Direction

Physician's Profile

Full Name	Dr Azam Ahmed Qureshi
Gender	Male
Speciality	Dermatology
Location	1515 Randolph Ct, Manitowoc, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1245899038
Provider Enumeration Date: 06/06/2019
Last Update Date: 08/18/2023

Medicare PECOS Information:

PECOS PAC ID: 5193052025
Enrollment ID: I20230824002282

Medical Identifiers

Medical identifiers for Dr Azam Ahmed Qureshi such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245899038	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207N00000X	Dermatology	100818-875 (Wisconsin)	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. Dr Azam Ahmed Qureshi allows following entities to bill medicare on his behalf.

Entity Name	Forefront Dermatology Sc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083768253 PECOS PAC ID: 3779471701 Enrollment ID: O20040310000252

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 Azam Ahmed Qureshi 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 Azam Ahmed Qureshi, MD 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008	Dr Azam Ahmed Qureshi, MD 1515 Randolph Ct, Manitowoc, WI 54220-8345 Ph: (920) 683-5278

Reviews and Comments

Dermatology Doctors in Manitowoc, WI

Dr. Susan Ann Keiler, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1515 Randolph Ct, Manitowoc, WI 54220 Phone: 920-683-5278 Fax: 920-686-9674
Kenneth Henry Katz, M.D. Dermatology Medicare: Medicare Enrolled Practice Location: 1515 Randolph Ct, Manitowoc, WI 54220 Phone: 920-683-5278 Fax: 920-686-9674
Henry M Katz, M.D. Dermatology Medicare: Not Enrolled in Medicare Practice Location: 2320 Logwood Ln, Manitowoc, WI 54220 Phone: 920-682-7124
Dr. Charles Leroy Frederick Schultz, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 801 York St, Manitowoc, WI 54220 Phone: 920-683-5278 Fax: 920-686-9674
Dr. Eric Morgan Hanson, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1515 Randolph Ct, Manitowoc, WI 54220 Phone: 920-683-5278 Fax: 920-683-2131
Betsy Jane Wernli, M.D Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1515 Randolph Ct, Manitowoc, WI 54220 Phone: 920-683-5278 Fax: 920-482-0359

Dr Azam Ahmed Qureshi, MD - Medicare Dermatology in Manitowoc, WI