Dr Laura Kooistra Archibald, MD in Bloomington, IN

Dr Laura Kooistra Archibald, MD is a medicare enrolled "Dermatology" physician in Bloomington, Indiana. Her current practice location is 415 S Landmark Ave, Bloomington, Indiana. You can reach out to her office (for appointments etc.) via phone at (812) 333-7433.

Dr Laura Kooistra Archibald is licensed to practice in Indiana (license number 01092483A) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1790348472.

Contact Information

	Dr Laura Kooistra Archibald, MD
	415 S Landmark Ave, Bloomington, IN 47403-5003
	(812) 333-7433
	(812) 333-7435

Map and Direction

Physician's Profile

Full Name	Dr Laura Kooistra Archibald
Gender	Female
Speciality	Dermatology
Location	415 S Landmark Ave, Bloomington, Indiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1790348472
Provider Enumeration Date: 04/17/2019
Last Update Date: 07/15/2024

Medicare PECOS Information:

PECOS PAC ID: 9537494679
Enrollment ID: I20230215002036

Medical Identifiers

Medical identifiers for Dr Laura Kooistra Archibald such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1790348472	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207ND0101X	Dermatology - Mohs-micrographic Surgery	01092483A (Indiana)	Secondary
207N00000X	Dermatology	01092483A (Indiana)	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 Laura Kooistra Archibald allows following entities to bill medicare on her behalf.

Entity Name	Park Nicollet Clinic
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046

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 Laura Kooistra Archibald 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 Laura Kooistra Archibald, MD 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008	Dr Laura Kooistra Archibald, MD 415 S Landmark Ave, Bloomington, IN 47403-5003 Ph: (812) 333-7433

Reviews and Comments

Dermatology Doctors in Bloomington, IN

Dr. Roxanne Rajaii, D.O. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1200 S Rogers St, Bloomington, IN 47403 Phone: 812-339-6434
Dr. Mary Kathleen Mctigue, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1200 S Rogers St, Bloomington, IN 47403 Phone: 812-339-6434 Fax: 812-331-0196
Michelle Gita Baechtold, MD Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1200 S Rogers St, Bloomington, IN 47403 Phone: 812-339-6434
Todd Nicholas Troxell, DO Dermatology Medicare: Medicare Enrolled Practice Location: 1010 W 2nd St, Bloomington, IN 47403 Phone: 812-200-2458 Fax: 930-200-8590
Talley Bhanyang Whang, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1200 S Rogers St, Bloomington, IN 47403 Phone: 812-339-6434
Dr. Eran V Chen, M.D. Dermatology Medicare: Accepting Medicare Assignments Practice Location: 1200 S Rogers St, Bloomington, IN 47403 Phone: 123-396-4348 Fax: 812-331-0196
Molly Bridget Kitley, MD Dermatology Medicare: Medicare Enrolled Practice Location: 1200 S Rogers St, Bloomington, IN 47403 Phone: 812-339-6434

Dr Laura Kooistra Archibald, MD - Medicare Dermatology in Bloomington, IN