Dr Isidro A Amigo, DO is a medicare enrolled "Surgery" physician in Grafton, West Virginia. His current practice location is
8 Rose St, Grafton, West Virginia. You can reach out to his office (for appointments etc.) via phone at
(304) 265-0095.
Dr Isidro A Amigo is licensed to practice in West Virginia (license number 1181) 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 1821049339.
Physician's Profile
| Full Name | Dr Isidro A Amigo |
|---|
| Gender | Male |
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| Speciality | Surgery |
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| Location | 8 Rose St, Grafton, West 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: 1821049339
- Provider Enumeration Date: 05/12/2006
- Last Update Date: 04/07/2016
Medicare PECOS Information:
- PECOS PAC ID: 5698722213
- Enrollment ID: I20130723000736
Medical Identifiers
Medical identifiers for Dr Isidro A Amigo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821049339 | NPI | - | NPPES |
| 0128645000 | Medicaid | WV | |
| 0551675 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208600000X | Surgery | 34002976 (Ohio) | Secondary |
| 208600000X | Surgery | 1181 (West 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 Isidro A Amigo allows following entities to bill medicare on his behalf.
| Entity Name | Vaughan Physician Practices, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467599621
PECOS PAC ID: 8123126851
Enrollment ID: O20070604000705 |
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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 Isidro A Amigo 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 Isidro A Amigo, DO
Po Box 42738,
Towson, MD 21284-2738
Ph: (844) 468-9502 | Dr Isidro A Amigo, DO
8 Rose St,
Grafton, WV 26354-1678
Ph: (304) 265-0095 |
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