Dr Douglas William Wisor, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Midlothian, Virginia. His current practice location is
13700 St Francis Blvd Ste 501, Midlothian, Virginia. You can reach out to his office (for appointments etc.) via phone at
(703) 914-8000.
Dr Douglas William Wisor is licensed to practice in Virginia (license number 0101052685) 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 1902874449.
Physician's Profile
| Full Name | Dr Douglas William Wisor |
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| Gender | Male |
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| Speciality | Pain Medicine - Interventional Pain Medicine |
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| Location | 13700 St Francis Blvd Ste 501, Midlothian, Virginia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1902874449
- Provider Enumeration Date: 03/10/2006
- Last Update Date: 07/11/2019
Medicare PECOS Information:
- PECOS PAC ID: 0547218695
- Enrollment ID: I20190419000141
Medical Identifiers
Medical identifiers for Dr Douglas William Wisor such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902874449 | NPI | - | NPPES |
| 6802966 | Medicaid | VA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | 010152685 (Virginia) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 0101052685 (Virginia) | 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 Douglas William Wisor allows following entities to bill medicare on his behalf.
| Entity Name | Interventional Pain Center Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1558428789
PECOS PAC ID: 9537071238
Enrollment ID: O20031103000025 |
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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 William Wisor 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 William Wisor, MD
11350 Mccormick Road, Executive Plaza 1, Suite 501,
Hunt Valley, MD 21031
Ph: (410) 329-1071 | Dr Douglas William Wisor, MD
13700 St Francis Blvd Ste 501,
Midlothian, VA 23114
Ph: (703) 914-8000 |
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