Dr John K Wildemore Iv, MD is a medicare enrolled "Dermatology" physician in Wayne, Pennsylvania. He went to Jefferson Medical College Of Thomas Jefferson University and graduated in 1996 and has 28 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice John K. Wildemore, Md, Llc and his current practice location is
744 W Lancaster Ave, Suite 230, Wayne, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at
(610) 688-8750.
Dr John K Wildemore Iv is licensed to practice in Pennsylvania (license number MD423121) 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 1295712487.
Physician's Profile
| Full Name | Dr John K Wildemore Iv |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 28 Years |
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| Location | 744 W Lancaster Ave, Wayne, Pennsylvania |
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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 John K Wildemore Iv attended and graduated from Jefferson Medical College Of Thomas Jefferson University in 1996
NPI Data:
- NPI Number: 1295712487
- Provider Enumeration Date: 12/28/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8729988555
- Enrollment ID: I20040109000407
Medical Identifiers
Medical identifiers for Dr John K Wildemore Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1295712487 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | MD423121 (Pennsylvania) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| John K. Wildemore, Md, Llc | 5698775104 | 4 |
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 John K Wildemore Iv allows following entities to bill medicare on his behalf.
| Entity Name | John K. Wildemore, Md, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376632257
PECOS PAC ID: 5698775104
Enrollment ID: O20070108000169 |
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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 John K Wildemore Iv 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 John K Wildemore Iv, MD
744 W Lancaster Ave, Suite 230,
Wayne, PA 19087-2523
Ph: (610) 688-8750 | Dr John K Wildemore Iv, MD
744 W Lancaster Ave, Suite 230,
Wayne, PA 19087-2523
Ph: (610) 688-8750 |
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