Jill Mallory Fadal Wilson, MD - Medicare Radiology in Park City, UT

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Jill Mallory Fadal Wilson, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Park City, Utah. Her current practice location is 1389 Center Dr Ste 200, Park City, Utah. You can reach out to her office (for appointments etc.) via phone at (970) 484-4757.

Jill Mallory Fadal Wilson is licensed to practice in Utah (license number 10964555-1205) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1275928897.

Contact Information

Jill Mallory Fadal Wilson, MD
1389 Center Dr Ste 200,
Park City, UT 84098-7660
(970) 484-4757
(970) 484-4759

Map and Direction




Physician's Profile

Full NameJill Mallory Fadal Wilson
GenderFemale
SpecialityRadiology - Diagnostic Radiology
Location1389 Center Dr Ste 200, Park City, Utah
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1275928897
  • Provider Enumeration Date: 03/31/2015
  • Last Update Date: 03/04/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 4587918586
  • Enrollment ID: I20230807001252

Medical Identifiers

Medical identifiers for Jill Mallory Fadal Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1275928897NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
2085R0202XRadiology - Diagnostic Radiology 15751A (Wyoming)Secondary
2085R0202XRadiology - Diagnostic Radiology DR.0070579 (Colorado)Secondary
2085R0202XRadiology - Diagnostic Radiology 10964555-1205 (Utah)Primary
2085R0202XRadiology - Diagnostic Radiology 35561 (Nebraska)Secondary

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. Jill Mallory Fadal Wilson allows following entities to bill medicare on her behalf.
Entity NameUniversity Of Utah Adult Services
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1114321981
PECOS PAC ID: 0941525273
Enrollment ID: O20150209001683
Entity NameFort Collins Radiologic Associates Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1003849498
PECOS PAC ID: 7315844396
Enrollment ID: O20230807000949

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. Jill Mallory Fadal Wilson 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
Jill Mallory Fadal Wilson, MD
2008 Caribou Dr,
Fort Collins, CO 80525-4325

Ph: (970) 484-4757		Jill Mallory Fadal Wilson, MD
1389 Center Dr Ste 200,
Park City, UT 84098-7660

Ph: (970) 484-4757

Reviews and Comments


Radiology Doctors in Park City, UT

William Randall Compton, M.D.
Radiology
Medicare: Not Enrolled in Medicare
Practice Location: 2531 Aspen Springs Dr, Park City, UT 84060
Phone: 435-615-9307    
John Manuel Arias, MD
Radiology
Medicare: Medicare Enrolled
Practice Location: 9010 Saddleback Rd, Park City, UT 84098
Phone: 952-595-1100    Fax: 952-942-3361

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.