Dr Neil William Wangstrom, MD is a medicare enrolled "Otolaryngology" physician in La Porte, Indiana. He went to Washington University School Of Medicine and graduated in 1985 and has 39 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice La Porte Clinic Company Llc and his current practice location is
304 Detroit St, La Porte, Indiana. You can reach out to his office (for appointments etc.) via phone at
(219) 325-3770.
Dr Neil William Wangstrom is licensed to practice in Indiana (license number 01038858) 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 1730189820.
Physician's Profile
Full Name | Dr Neil William Wangstrom |
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Gender | Male |
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Speciality | Otolaryngology |
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Experience | 39 Years |
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Location | 304 Detroit St, La Porte, Indiana |
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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. |
Medical Education and Training:
- Dr Neil William Wangstrom attended and graduated from Washington University School Of Medicine in 1985
NPI Data:
- NPI Number: 1730189820
- Provider Enumeration Date: 07/29/2005
- Last Update Date: 09/16/2020
Medicare PECOS Information:
- PECOS PAC ID: 2062474414
- Enrollment ID: I20041028000846
Medical Identifiers
Medical identifiers for Dr Neil William Wangstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1730189820 | NPI | - | NPPES |
M400041676 | Other | IN | MEDICARE PTAN |
000000697664 | Other | IN | ANTHEM |
100165330 | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Y00000X | Otolaryngology | 01038858 (Indiana) | Primary |
207YP0228X | Otolaryngology - Pediatric Otolaryngology | 01038858 (Indiana) | Secondary |
207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 01038858 (Indiana) | Secondary |
207YX0602X | Otolaryngology - Otolaryngic Allergy | 01038858 (Indiana) | Secondary |
207YX0901X | Otolaryngology - Otology & Neurotology | 01038858 (Indiana) | Secondary |
207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery | 01038858 (Indiana) | Secondary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
La Porte Clinic Company Llc | 0446558357 | 61 |
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 Neil William Wangstrom allows following entities to bill medicare on his behalf.
Entity Name | Indiana University Health La Porte Physicians Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1760593776 PECOS PAC ID: 0345147963 Enrollment ID: O20031212000670 |
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Entity Name | La Porte Clinic Company Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1568829224 PECOS PAC ID: 0446558357 Enrollment ID: O20160408001751 |
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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 Neil William Wangstrom 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 Neil William Wangstrom, MD Po Box 1690, La Porte, IN 46352-1690 Ph: (219) 326-2312 | Dr Neil William Wangstrom, MD 304 Detroit St, La Porte, IN 46350-2497 Ph: (219) 325-3770 |
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