Paul M Ditmanson, MD is a medicare enrolled "Family Medicine" physician in Red Lake, Minnesota. His current practice location is
Hwy 1 Box 497, Phs Indian Hospital, Red Lake, Minnesota. You can reach out to his office (for appointments etc.) via phone at
(218) 679-3912.
Paul M Ditmanson is licensed to practice in Minnesota (license number 30915) 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 1922181676.
Physician's Profile
Full Name | Paul M Ditmanson |
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Gender | Male |
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Speciality | Family Medicine |
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Location | Hwy 1 Box 497, Red Lake, Minnesota |
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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: 1922181676
- Provider Enumeration Date: 10/23/2006
- Last Update Date: 11/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0840459723
- Enrollment ID: I20120313000274
Medical Identifiers
Medical identifiers for Paul M Ditmanson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1922181676 | NPI | - | NPPES |
476753500 | Medicaid | MN | |
30915 | Other | MN | MINNESOTA LICENSE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 30915 (Minnesota) | 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. Paul M Ditmanson allows following entities to bill medicare on his behalf.
Entity Name | Phs Indian Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1508809765 PECOS PAC ID: 4789598731 Enrollment ID: O20031114000287 |
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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. Paul M Ditmanson 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 |
Paul M Ditmanson, MD Hwy 1 Box 497, Phs Indian Hospital, Red Lake, MN 56671 Ph: (218) 679-3912 | Paul M Ditmanson, MD Hwy 1 Box 497, Phs Indian Hospital, Red Lake, MN 56671 Ph: (218) 679-3912 |
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