Whitney Blaire Fancher, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Longview, Washington. She went to University Of Missouri, Columbia School Of Medicine and graduated in 2011 and has 14 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Blue Valley Dermatology Llc and her current practice location is
1106 Douglas St Ste F, Longview, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 636-4500.
Whitney Blaire Fancher is licensed to practice in Oregon (license number MD177022) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1053699645.
Physician's Profile
| Full Name | Whitney Blaire Fancher |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 14 Years |
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| Location | 1106 Douglas St Ste F, Longview, Washington |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Whitney Blaire Fancher attended and graduated from University Of Missouri, Columbia School Of Medicine in 2011
NPI Data:
- NPI Number: 1053699645
- Provider Enumeration Date: 07/30/2011
- Last Update Date: 02/10/2021
Medicare PECOS Information:
- PECOS PAC ID: 0749595296
- Enrollment ID: I20230607000566
Medical Identifiers
Medical identifiers for Whitney Blaire Fancher such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053699645 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | 125059648 (Illinois) | Secondary |
| 207N00000X | Dermatology | MD60644753 (Washington) | Secondary |
| 207N00000X | Dermatology | MD177022 (Oregon) | Secondary |
| 207N00000X | Dermatology | 63662 (Wisconsin) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | MD60644753 (Washington) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 63662 (Wisconsin) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | MD177022 (Oregon) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Blue Valley Dermatology Llc | 9133499973 | 8 |
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. Whitney Blaire Fancher allows following entities to bill medicare on her behalf.
| Entity Name | Blue Valley Dermatology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1104354794
PECOS PAC ID: 9133499973
Enrollment ID: O20170726003732 |
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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. Whitney Blaire Fancher 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 |
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Whitney Blaire Fancher, MD
1793 13th St Se,
Salem, OR 97302-2541
Ph: (503) 362-8385 | Whitney Blaire Fancher, MD
1106 Douglas St Ste F,
Longview, WA 98632-2429
Ph: (360) 636-4500 |
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