Marie Brown-wagner, MD is a medicare enrolled "Otolaryngology - Plastic Surgery Within The Head & Neck" physician in Shiprock, New Mexico. Her current practice location is
Us Hwy 491 North, Shiprock, New Mexico. You can reach out to her office (for appointments etc.) via phone at
(505) 368-6401.
Marie Brown-wagner is licensed to practice in Colorado (license number 50773) 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 1134235385.
Physician's Profile
Full Name | Marie Brown-wagner |
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Gender | Female |
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Speciality | Otolaryngology - Plastic Surgery Within The Head & Neck |
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Location | Us Hwy 491 North, Shiprock, New Mexico |
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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: 1134235385
- Provider Enumeration Date: 08/21/2006
- Last Update Date: 02/02/2012
Medicare PECOS Information:
- PECOS PAC ID: 9335273440
- Enrollment ID: I20121101000616
Medical Identifiers
Medical identifiers for Marie Brown-wagner such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1134235385 | NPI | - | NPPES |
022392 | Other | CO | KAISER COMMERCIAL NUMBER |
621830 | Medicaid | AZ | |
G7888 | Medicaid | NM | |
23083336 | Medicaid | CO | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Y00000X | Otolaryngology | 131753-2 (New York) | Secondary |
207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 50773 (Colorado) | 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. Marie Brown-wagner allows following entities to bill medicare on her behalf.
Entity Name | Presbyterian Healthcare Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1104802354 PECOS PAC ID: 9234041708 Enrollment ID: O20031103000603 |
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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. Marie Brown-wagner 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 |
Marie Brown-wagner, MD Po Box 160, Shiprock, NM 87420-0160 Ph: (505) 368-6401 | Marie Brown-wagner, MD Us Hwy 491 North, Shiprock, NM 87420 Ph: (505) 368-6401 |
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