Dr Nathan Patrick Widboom, DO is a medicare enrolled "Neuromusculoskeletal Medicine & Omm" physician in South Miami, Florida. He graduated from medical school in 2012 and has 12 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Nova Southeastern University Inc and his current practice location is
7031 Sw 62nd Ave, South Miami, Florida. You can reach out to his office (for appointments etc.) via phone at
(305) 284-7761.
Dr Nathan Patrick Widboom is licensed to practice in Florida (license number OS13591) 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 1144565532.
Physician's Profile
| Full Name | Dr Nathan Patrick Widboom |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 12 Years |
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| Location | 7031 Sw 62nd Ave, South Miami, Florida |
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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 Nathan Patrick Widboom graduated from medical school in 2012
NPI Data:
- NPI Number: 1144565532
- Provider Enumeration Date: 12/11/2012
- Last Update Date: 02/26/2020
Medicare PECOS Information:
- PECOS PAC ID: 6204119993
- Enrollment ID: I20170202002049
Medical Identifiers
Medical identifiers for Dr Nathan Patrick Widboom such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1144565532 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | OS13591 (Florida) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 204D00000X | Neuromusculoskeletal Medicine & Omm | OS13591 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Nova Southeastern University Inc | 4486568896 | 84 |
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 Nathan Patrick Widboom allows following entities to bill medicare on his behalf.
| Entity Name | Nova Southeastern University Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1700924511
PECOS PAC ID: 4486568896
Enrollment ID: O20031118000987 |
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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 Nathan Patrick Widboom 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 Nathan Patrick Widboom, DO
7031 Sw 62nd Ave,
South Miami, FL 33143-4701
Ph: (305) 284-7761 | Dr Nathan Patrick Widboom, DO
7031 Sw 62nd Ave,
South Miami, FL 33143-4701
Ph: (305) 284-7761 |
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