Michael Mazzotta, MD in Portland, OR - Medicare Internal Medicine

Michael Mazzotta, MD is a medicare enrolled "Internal Medicine" physician in Portland, Oregon. His current practice location is 4212 Ne Broadway, Medical Staff Svcs, Portland, Oregon. You can reach out to his office (for appointments etc.) via phone at (503) 382-7709.

Michael Mazzotta is licensed to practice in Oregon (license number 173217) 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 1841427572.

Contact Information

	Michael Mazzotta, MD
	4212 Ne Broadway, Medical Staff Svcs, Portland, OR 97213-1422
	(503) 382-7709
	(503) 382-7706

Map and Direction

Physician's Profile

Full Name	Michael Mazzotta
Gender	Male
Speciality	Internal Medicine
Location	4212 Ne Broadway, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1841427572
Provider Enumeration Date: 06/21/2009
Last Update Date: 02/01/2022

Medicare PECOS Information:

PECOS PAC ID: 3072748185
Enrollment ID: I20170109001556

Medical Identifiers

Medical identifiers for Michael Mazzotta such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841427572	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	173217 (Oregon)	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. Michael Mazzotta allows following entities to bill medicare on his behalf.

Entity Name	Kaiser Foundation Health Plan Of The Northwest
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040130000799

Entity Name	Broadway Medical Clinic Llp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720082316 PECOS PAC ID: 2466447610 Enrollment ID: O20040416001171

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. Michael Mazzotta 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
Michael Mazzotta, MD 4212 Ne Broadway, Medical Staff Svcs, Portland, OR 97213-1422 Ph: (503) 382-7709	Michael Mazzotta, MD 4212 Ne Broadway, Medical Staff Svcs, Portland, OR 97213-1422 Ph: (503) 382-7709

Reviews and Comments

Internal Medicine Doctors in Portland, OR

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Dr. Victor Nguyen Pham, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 9205 Sw Barnes Rd, Portland, OR 97225 Phone: 503-216-2906
Richa Uppal, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 800 Sw 13th Ave, Portland, OR 97205 Phone: 503-221-0161 Fax: 503-274-1697
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Michael Mazzotta, MD - Medicare Internal Medicine in Portland, OR