Dr Vincent Lucas David Fryer, MD is a medicare enrolled "General Practice" physician in Suamico, Wisconsin. His current practice location is
2329 Sunny Ln Apt C, Suamico, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(801) 554-4882.
Dr Vincent Lucas David Fryer is licensed to practice in Wisconsin (license number 71760-20) 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 1073017265.
Physician's Profile
Full Name | Dr Vincent Lucas David Fryer |
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Gender | Male |
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Speciality | General Practice |
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Location | 2329 Sunny Ln Apt C, Suamico, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1073017265
- Provider Enumeration Date: 03/21/2018
- Last Update Date: 11/27/2019
Medicare PECOS Information:
- PECOS PAC ID: 7618308743
- Enrollment ID: I20200505002793
Medical Identifiers
Medical identifiers for Dr Vincent Lucas David Fryer such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1073017265 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 71760-20 (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 Vincent Lucas David Fryer allows following entities to bill medicare on his behalf.
Entity Name | Signify Health Medical Associates Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1750845863 PECOS PAC ID: 2163764424 Enrollment ID: O20191118000551 |
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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 Vincent Lucas David Fryer 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 Vincent Lucas David Fryer, MD 2329 Sunny Ln Apt C, Suamico, WI 54313-7821 Ph: (801) 554-4882 | Dr Vincent Lucas David Fryer, MD 2329 Sunny Ln Apt C, Suamico, WI 54313-7821 Ph: (801) 554-4882 |
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