Hind Mirza Gautam, MD in De Pere, WI - Medicare Interventional Pain Management

Hind Mirza Gautam, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in De Pere, Wisconsin. She graduated from medical school in 1997 and has 27 years of diverse experience with area of expertise as Interventional Pain Management. She is a member of the group practice Aurora Medical Group, Inc. and her current practice location is 1881 Chicago St, De Pere, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 403-8000.

Hind Mirza Gautam is licensed to practice in Wisconsin (license number 49944) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1316950504.

Contact Information

	Hind Mirza Gautam, MD
	1881 Chicago St, De Pere, WI 54115-3770
	(920) 403-8000
	Not Available

Map and Direction

Physician's Profile

Full Name	Hind Mirza Gautam
Gender	Female
Speciality	Interventional Pain Management
Experience	27 Years
Location	1881 Chicago St, De Pere, Wisconsin
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Hind Mirza Gautam graduated from medical school in 1997

NPI Data:

NPI Number: 1316950504
Provider Enumeration Date: 08/15/2006
Last Update Date: 01/08/2024

Medicare PECOS Information:

PECOS PAC ID: 5991807075
Enrollment ID: I20070220000299

Medical Identifiers

Medical identifiers for Hind Mirza Gautam such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1316950504	NPI	-	NPPES
34748200	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208VP0014X	Pain Medicine - Interventional Pain Medicine	49944 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Aurora Baycare Medical Ctr	Green bay, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Aurora Medical Group, Inc.	6709794258	3269

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. Hind Mirza Gautam allows following entities to bill medicare on her behalf.

Entity Name	Aurora Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725

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. Hind Mirza Gautam 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
Hind Mirza Gautam, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250	Hind Mirza Gautam, MD 1881 Chicago St, De Pere, WI 54115-3770 Ph: (920) 403-8000

Hind Mirza Gautam, MD - Medicare Interventional Pain Management in De Pere, WI