Eric Wideburg, DO - Medicare Radiology in Thiensville, WI

  1. Home
  2. Radiology
  3. WI
  4. Thiensville
Eric Wideburg, DO is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Thiensville, Wisconsin. His current practice location is 10945 N Port Washington Rd Ste 201, Thiensville, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (262) 292-3151.

Eric Wideburg is licensed to practice in Wisconsin (license number 72422-21) 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 1679004469.

Contact Information

Eric Wideburg, DO
10945 N Port Washington Rd Ste 201,
Thiensville, WI 53092-5078
(262) 292-3151
(262) 643-4707

Map and Direction




Physician's Profile

Full NameEric Wideburg
GenderMale
SpecialityRadiology - Diagnostic Radiology
Location10945 N Port Washington Rd Ste 201, Thiensville, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1679004469
  • Provider Enumeration Date: 03/23/2017
  • Last Update Date: 08/15/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7416301387
  • Enrollment ID: I20230926002570

Medical Identifiers

Medical identifiers for Eric Wideburg such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1679004469NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology 72422-21 (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. Eric Wideburg allows following entities to bill medicare on his behalf.
Entity NameWisconsin Radiology Specialists Sc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1568446003
PECOS PAC ID: 2961314091
Enrollment ID: O20031105000585
Entity NamePremier Radiology Wisconsin Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1952951154
PECOS PAC ID: 9537595533
Enrollment ID: O20200211002818
Entity NamePrecision Radiology - Illinois Ltd
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1265156640
PECOS PAC ID: 6305218298
Enrollment ID: O20230201002800

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. Eric Wideburg 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 AddressPractice Location Address
Eric Wideburg, DO
Po Box 713121,
Chicago, IL 60677-0321

Ph: (262) 292-3151		Eric Wideburg, DO
10945 N Port Washington Rd Ste 201,
Thiensville, WI 53092-5078

Ph: (262) 292-3151

Reviews and Comments


Radiology Doctors in Thiensville, WI

Kaleen D Puccetti,
Radiology
Medicare: Medicare Enrolled
Practice Location: 10945 N Port Washington Rd, Thiensville, WI 53092
Phone: 262-292-3151    
Jordan Alexander Kapke, MD
Radiology
Medicare: Accepting Medicare Assignments
Practice Location: 10945 N Port Washington Rd Ste 201, Thiensville, WI 53092
Phone: 262-292-3151    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.