Dr Rahmatollah O Simani, MD is a medicare enrolled "General Practice" physician in Friendship, Wisconsin. His current practice location is
402 W Lake St, Friendship, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(608) 339-3331.
Dr Rahmatollah O Simani is licensed to practice in Wisconsin (license number 17974) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1104895010.
Physician's Profile
| Full Name | Dr Rahmatollah O Simani |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 402 W Lake St, Friendship, 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: 1104895010
- Provider Enumeration Date: 03/14/2006
- Last Update Date: 08/13/2012
Medicare PECOS Information:
- PECOS PAC ID: 7810911286
- Enrollment ID: I20060124000975
Medical Identifiers
Medical identifiers for Dr Rahmatollah O Simani such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104895010 | NPI | - | NPPES |
| 30970900 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208D00000X | General Practice | 17974 (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 Rahmatollah O Simani allows following entities to bill medicare on his behalf.
| Entity Name | Moundview Memorial Hospital & Clinics Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1710939533
PECOS PAC ID: 1355250432
Enrollment ID: O20031121000846 |
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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 Rahmatollah O Simani 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 Rahmatollah O Simani, MD
Po Box 40,
Friendship, WI 53934-0040
Ph: (608) 339-3331 | Dr Rahmatollah O Simani, MD
402 W Lake St,
Friendship, WI 53934-9699
Ph: (608) 339-3331 |
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