Port Washington Podiatry Inc is a medicare enrolled "Podiatrist" provider in Port Washington, Wisconsin. Their current practice location is
1317 W Grand Avenue, Port Washington Podiatry, Port Washington, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(262) 284-8800.
Port Washington Podiatry Inc is licensed to practice in Wisconsin (license number 798025) and it also participates in the medicare program. Port Washington Podiatry Inc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1013953926.
Healthcare Provider's Profile
| Full Name | Port Washington Podiatry Inc |
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| Type | Facility |
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| Speciality | Podiatrist |
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| Location | 1317 W Grand Avenue, Port Washington, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1013953926
- Provider Enumeration Date: 06/20/2006
- Last Update Date: 04/20/2008
Medicare PECOS Information:
- PECOS PAC ID: 0042291031
- Enrollment ID: O20040526000541
Medical Identifiers
Medical identifiers for Port Washington Podiatry Inc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1013953926 | NPI | - | NPPES |
| DB0746 | Other | | RR MCR |
| 43268200 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | 798025 (Wisconsin) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Port Washington Podiatry Inc acts as a billing entity for following providers:
| Provider Name | Jeffrey J Bongiorno |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1770599953
PECOS PAC ID: 1759362759
Enrollment ID: I20040528000686 |
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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. Port Washington Podiatry Inc 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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Port Washington Podiatry Inc
2132 Willow Pond Way,
Grafton, WI 53024-9102
Ph: (262) 284-8800 | Port Washington Podiatry Inc
1317 W Grand Avenue, Port Washington Podiatry,
Port Washington, WI 53074
Ph: (262) 284-8800 |
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