Walstir H Fonseca, MD is a medicare enrolled "Internal Medicine" physician in Lindon, Utah. Her current practice location is
76 S Kings Peak Dr, Lindon, Utah. You can reach out to her office (for appointments etc.) via phone at
(801) 370-5193.
Walstir H Fonseca is licensed to practice in Utah (license number 329175-1205) 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 1013933506.
Physician's Profile
Full Name | Walstir H Fonseca |
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Gender | Female |
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Speciality | Internal Medicine |
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Location | 76 S Kings Peak Dr, Lindon, Utah |
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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: 1013933506
- Provider Enumeration Date: 07/15/2006
- Last Update Date: 11/23/2021
Medicare PECOS Information:
- PECOS PAC ID: 0547247223
- Enrollment ID: I20040630000977
Medical Identifiers
Medical identifiers for Walstir H Fonseca such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013933506 | NPI | - | NPPES |
04-00322 | Other | UT | UNITED HEALTHCARE |
110166693 | Other | UT | PALMETTO |
QM0000000074 | Other | UT | ALTIUS |
286636 | Other | UT | DMBA |
46639 | Other | UT | PEHP |
870281028FO1 | Other | UT | EMIA |
107007883101 | Other | UT | IHC |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 329175-1205 (Utah) | 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. Walstir H Fonseca allows following entities to bill medicare on her behalf.
Entity Name | Central Utah Clinic Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
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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. Walstir H Fonseca 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 |
Walstir H Fonseca, MD 76 S Kings Peak Dr, Lindon, UT 84042-2223 Ph: (801) 370-5193 | Walstir H Fonseca, MD 76 S Kings Peak Dr, Lindon, UT 84042-2223 Ph: (801) 370-5193 |
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