Dr Kavita Mariwalla, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in West Islip, New York. She went to Yale University School Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Micrographic Dermatologic Surgery (mds). She is a member of the group practice Mariwalla Dermatology Pllc and her current practice location is
1253 Montauk Highway, West Islip, New York. You can reach out to her office (for appointments etc.) via phone at
(631) 665-3376.
Dr Kavita Mariwalla is licensed to practice in Connecticut (license number 046352) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1962674184.
Physician's Profile
| Full Name | Dr Kavita Mariwalla |
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| Gender | Female |
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| Speciality | Micrographic Dermatologic Surgery (mds) |
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| Experience | 20 Years |
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| Location | 1253 Montauk Highway, West Islip, New York |
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| Accepts Medicare Assignments | Yes. She 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 Kavita Mariwalla attended and graduated from Yale University School Of Medicine in 2004
NPI Data:
- NPI Number: 1962674184
- Provider Enumeration Date: 03/27/2008
- Last Update Date: 09/28/2020
Medicare PECOS Information:
- PECOS PAC ID: 3678646064
- Enrollment ID: I20090904000346
Medical Identifiers
Medical identifiers for Dr Kavita Mariwalla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962674184 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 046352 (Connecticut) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 253189 (New York) | Secondary |
| 207N00000X | Dermatology | 253189 (New York) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 046352 (Connecticut) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Mariwalla Dermatology Pllc | 5799962676 | 3 |
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 Kavita Mariwalla allows following entities to bill medicare on her behalf.
| Entity Name | Mariwalla Dermatology Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891094322
PECOS PAC ID: 5799962676
Enrollment ID: O20110601000420 |
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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 Kavita Mariwalla 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 Kavita Mariwalla, MD
1253 Montauk Highway,
West Islip, NY 11795-4916
Ph: (631) 665-3376 | Dr Kavita Mariwalla, MD
1253 Montauk Highway,
West Islip, NY 11795-4916
Ph: (631) 665-3376 |
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