Susan Provow, MD is a medicare enrolled "Family Medicine" physician in Rock Falls, Illinois. Her current practice location is
100 W 1st St, Rock Falls, Illinois. You can reach out to her office (for appointments etc.) via phone at
(815) 625-4790.
Susan Provow is licensed to practice in Illinois (license number ) 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 1861580128.
Physician's Profile
Full Name | Susan Provow |
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Gender | Female |
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Speciality | Family Medicine |
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Location | 100 W 1st St, Rock Falls, Illinois |
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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: 1861580128
- Provider Enumeration Date: 10/11/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 5890803928
- Enrollment ID: I20101019000956
Medical Identifiers
Medical identifiers for Susan Provow such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1861580128 | NPI | - | NPPES |
9815737 | Other | IL | BLUE CROSS BLUE SHIELD |
011542 | Other | IL | HEALTH ALLIANCE MEDICAL |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | (Illinois) | 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. Susan Provow allows following entities to bill medicare on her behalf.
Entity Name | Cgh Medical Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1902854623 PECOS PAC ID: 6103723267 Enrollment ID: O20031217000054 |
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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. Susan Provow 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 |
Susan Provow, MD 101 E Miller Rd, Sterling, IL 61081-1252 Ph: (815) 625-4790 | Susan Provow, MD 100 W 1st St, Rock Falls, IL 61071-1269 Ph: (815) 625-4790 |
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