Dr Douglas John Raedy, DO is a medicare enrolled "Otolaryngology" physician in Portage, Michigan. He graduated from medical school in 1982 and has 42 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Three Rivers Health System Inc and his current practice location is
3850 Glenkerry Ct, Portage, Michigan. You can reach out to his office (for appointments etc.) via phone at
(269) 327-7200.
Dr Douglas John Raedy is licensed to practice in Michigan (license number DR009649) 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 1215111885.
Physician's Profile
| Full Name | Dr Douglas John Raedy |
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| Gender | Male |
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| Speciality | Otolaryngology |
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| Experience | 42 Years |
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| Location | 3850 Glenkerry Ct, Portage, Michigan |
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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 Douglas John Raedy graduated from medical school in 1982
NPI Data:
- NPI Number: 1215111885
- Provider Enumeration Date: 12/19/2007
- Last Update Date: 05/10/2011
Medicare PECOS Information:
- PECOS PAC ID: 1052365673
- Enrollment ID: I20110429000079
Medical Identifiers
Medical identifiers for Dr Douglas John Raedy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215111885 | NPI | - | NPPES |
| 2745903 | Medicaid | MI | |
| 1753900045 | Other | MI | BLUE CROSS BLUE SHIELDI |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Y00000X | Otolaryngology | DR009649 (Michigan) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Three Rivers Health System Inc | 8729245584 | 32 |
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 Douglas John Raedy allows following entities to bill medicare on his behalf.
| Entity Name | West Michigan Ear Nose & Throat Plc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154365849
PECOS PAC ID: 8224213632
Enrollment ID: O20110429000057 |
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| Entity Name | Three Rivers Health System Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720350903
PECOS PAC ID: 8729245584
Enrollment ID: O20140729001948 |
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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 Douglas John Raedy 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 |
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Dr Douglas John Raedy, DO
3850 Glenkerry Ct,
Portage, MI 49024-0700
Ph: (269) 327-7200 | Dr Douglas John Raedy, DO
3850 Glenkerry Ct,
Portage, MI 49024-0700
Ph: (269) 327-7200 |
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