Dr Eric E Liedtke, DO in Ogden, UT - Medicare General Surgery

Dr Eric E Liedtke, DO is a medicare enrolled "Surgery" physician in Ogden, Utah. He went to Lake Erie College Of Osteopathic Medicine, Erie and graduated in 2005 and has 19 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice Ogden Clinic Specialty Services Llc and his current practice location is 4650 Harrison Blvd, Ogden, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 475-3010.

Dr Eric E Liedtke is licensed to practice in Utah (license number 12168421-1204) 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 1366624330.

Contact Information

	Dr Eric E Liedtke, DO
	4650 Harrison Blvd, Ogden, UT 84403-4303
	(801) 475-3010
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Eric E Liedtke
Gender	Male
Speciality	General Surgery
Experience	19 Years
Location	4650 Harrison Blvd, Ogden, Utah
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Eric E Liedtke attended and graduated from Lake Erie College Of Osteopathic Medicine, Erie in 2005

NPI Data:

NPI Number: 1366624330
Provider Enumeration Date: 12/03/2007
Last Update Date: 06/15/2021

Medicare PECOS Information:

PECOS PAC ID: 1153567482
Enrollment ID: I20210622002566

Medical Identifiers

Medical identifiers for Dr Eric E Liedtke such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366624330	NPI	-	NPPES
1366624330	Medicaid	UT
P01526646	Other	WA	RR MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	20A12096 (California)	Secondary
208600000X	Surgery	OP60582410 (Washington)	Secondary
208600000X	Surgery	12168421-1204 (Utah)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Ogden Regional Medical Center	Ogden, UT	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Ogden Clinic Specialty Services Llc	1658781422	108

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 Eric E Liedtke allows following entities to bill medicare on his behalf.

Entity Name	Ogden Clinic Specialty Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114203668 PECOS PAC ID: 1658781422 Enrollment ID: O20201105001806

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 Eric E Liedtke 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 Eric E Liedtke, DO Po Box 5546, Denver, CO 80217-5546 Ph: (801) 475-3500	Dr Eric E Liedtke, DO 4650 Harrison Blvd, Ogden, UT 84403-4303 Ph: (801) 475-3010

Reviews and Comments

Surgery Doctors in Ogden, UT

Mr. Lee Jeppson Malan, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 3955 Harrison Blvd, Suite U1, Ogden, UT 84403 Phone: 801-621-3591 Fax: 801-393-0836
Dr. Joseph E Hansler, Surgery Medicare: Accepting Medicare Assignments Practice Location: 4403 Harrison Blvd, Suite 1635, Ogden, UT 84403 Phone: 801-387-7450
Dr. Brian Craig Adams, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 3903 Harrison Blvd, Suite 100, Ogden, UT 84403 Phone: 801-387-8900 Fax: 801-387-8920
Faheem Akhtar, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 3903 Harrison Blvd., Suite 100, Ogden, UT 84403 Phone: 801-387-8900 Fax: 801-387-8920
Athanasios Bramos, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 4401 Harrison Blvd, Ogden, UT 84403 Phone: 801-387-2800
Elizabeth Franzen Nelson, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 3903 Harrison Blvd Ste 100, Ogden, UT 84403 Phone: 801-387-8900
Dr. Lyle H Archibald, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 4403 Harrison Blvd Ste 1635, Ogden, UT 84403 Phone: 801-387-7450

Dr Eric E Liedtke, DO - Medicare General Surgery in Ogden, UT