Wisam Al-mutawalli, MD in Camillus, NY - Medicare Family Medicine

Wisam Al-mutawalli, MD is a medicare enrolled "Family Medicine" physician in Camillus, New York. His current practice location is 208 Township Blvd, Ste 100, Camillus, New York. You can reach out to his office (for appointments etc.) via phone at (315) 551-6000.

Wisam Al-mutawalli is licensed to practice in New York (license number 332191) 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 1164005526.

Contact Information

	Wisam Al-mutawalli, MD
	208 Township Blvd, Ste 100, Camillus, NY 13031
	(315) 551-6000
	Not Available

Map and Direction

Physician's Profile

Full Name	Wisam Al-mutawalli
Gender	Male
Speciality	Family Medicine
Location	208 Township Blvd, Camillus, New York
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164005526
Provider Enumeration Date: 05/04/2021
Last Update Date: 10/23/2024

Medicare PECOS Information:

PECOS PAC ID: 7012456437
Enrollment ID: I20240829002761

Medical Identifiers

Medical identifiers for Wisam Al-mutawalli such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164005526	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	332191 (New York)	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. Wisam Al-mutawalli allows following entities to bill medicare on his behalf.

Entity Name	Upstate Family And Preventive Medicine Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1073988911 PECOS PAC ID: 6800185711 Enrollment ID: O20160517000789

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. Wisam Al-mutawalli 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
Wisam Al-mutawalli, MD 208 Township Blvd, Ste 100, Camillus, NY 13031 Ph: (315) 551-6000	Wisam Al-mutawalli, MD 208 Township Blvd, Ste 100, Camillus, NY 13031 Ph: (315) 551-6000

Reviews and Comments

Family Medicine Doctors in Camillus, NY

Thomas J Laclair, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 436 Hinsdale Rd, Camillus, NY 13031 Phone: 315-488-0996 Fax: 315-488-1955
Dennis David Daly, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5700 W Genesee St, Camillus, NY 13031 Phone: 315-487-1573 Fax: 315-487-2418
James Francis Lawless, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 436 Hinsdale Rd, Camillus, NY 13031 Phone: 315-488-0996 Fax: 315-488-1955
David Thurber Page, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 436 Hinsdale Rd, Camillus, NY 13031 Phone: 315-488-0996 Fax: 315-488-1955
Dr. David Thomas Hope, D.O. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 5415 W Genesee St, Suite 301, Camillus, NY 13031 Phone: 315-487-8109 Fax: 315-487-5680
Henry William Schoeneck, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5700 W Genesee St, Camillus, NY 13031 Phone: 315-487-1573 Fax: 315-487-2418

Wisam Al-mutawalli, MD - Medicare Family Medicine in Camillus, NY