Dr Linda Olson Douglas, MD is a medicare enrolled "Family Medicine" physician in Ixonia, Wisconsin. Her current practice location is
W1046 Marietta Ave, Suite 230, Ixonia, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(920) 206-6310.
Dr Linda Olson Douglas is licensed to practice in Wisconsin (license number 38840) 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 1538110515.
Physician's Profile
| Full Name | Dr Linda Olson Douglas |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | W1046 Marietta Ave, Ixonia, Wisconsin |
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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: 1538110515
- Provider Enumeration Date: 05/13/2006
- Last Update Date: 08/27/2013
Medicare PECOS Information:
- PECOS PAC ID: 6103911342
- Enrollment ID: I20071002000775
Medical Identifiers
Medical identifiers for Dr Linda Olson Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538110515 | NPI | - | NPPES |
| 32349600 | Medicaid | WI | |
| 002000216D | Other | | HUMANA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 38840 (Wisconsin) | 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 Linda Olson Douglas allows following entities to bill medicare on her behalf.
| Entity Name | Group Health Cooperative Of South Central Wisconsin |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1245260165
PECOS PAC ID: 3870489586
Enrollment ID: O20040227000306 |
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| Entity Name | Froedtert &the Medical College Of Wisconsin Community Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568787448
PECOS PAC ID: 3678760063
Enrollment ID: O20101210000699 |
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| Entity Name | Watertown Physician Practices Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1770964363
PECOS PAC ID: 8022329408
Enrollment ID: O20150626000114 |
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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 Linda Olson Douglas 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 Linda Olson Douglas, MD
W1046 Marietta Ave, Suite 230,
Ixonia, WI 53036-9498
Ph: (920) 206-6310 | Dr Linda Olson Douglas, MD
W1046 Marietta Ave, Suite 230,
Ixonia, WI 53036-9498
Ph: (920) 206-6310 |
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