Dr Audra Luz Kathleena Wisham, MD in Newport, OR

Dr Audra Luz Kathleena Wisham, MD is a medicare enrolled "Emergency Medicine" physician in Newport, Oregon. She went to Loma Linda University School Of Medicine and graduated in 2014 and has 10 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Montgomery Emergency Group, Llc and her current practice location is 930 Sw Abbey St, Newport, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 265-2244.

Dr Audra Luz Kathleena Wisham is licensed to practice in Oregon (license number MD182496) 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 1477961308.

Contact Information

	Dr Audra Luz Kathleena Wisham, MD
	930 Sw Abbey St, Newport, OR 97365-4820
	(541) 265-2244
	(541) 574-1838

Map and Direction

Physician's Profile

Full Name	Dr Audra Luz Kathleena Wisham
Gender	Female
Speciality	Emergency Medicine
Experience	10 Years
Location	930 Sw Abbey St, Newport, Oregon
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Audra Luz Kathleena Wisham attended and graduated from Loma Linda University School Of Medicine in 2014

NPI Data:

NPI Number: 1477961308
Provider Enumeration Date: 07/23/2014
Last Update Date: 11/02/2020

Medicare PECOS Information:

PECOS PAC ID: 3375816150
Enrollment ID: I20230728002595

Medical Identifiers

Medical identifiers for Dr Audra Luz Kathleena Wisham such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477961308	NPI	-	NPPES
500729523	Medicaid	OR

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	MD182496 (Oregon)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Meadows Regional Medical Center	Vidalia, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Montgomery Emergency Group, Llc	5395918387	16

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. Dr Audra Luz Kathleena Wisham allows following entities to bill medicare on her behalf.

Entity Name	Montgomery Emergency Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861773764 PECOS PAC ID: 5395918387 Enrollment ID: O20111108000598

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. Dr Audra Luz Kathleena Wisham 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
Dr Audra Luz Kathleena Wisham, MD Po Box 2847, Corvallis, OR 97339-2847 Ph: () -	Dr Audra Luz Kathleena Wisham, MD 930 Sw Abbey St, Newport, OR 97365-4820 Ph: (541) 265-2244

Reviews and Comments

Emergency Medicine Doctors in Newport, OR

Bradley Brian Hubbard, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 930 Sw Abbey St, Newport, OR 97365 Phone: 541-574-1818 Fax: 541-574-1831
Dr. William Randolph Fraser, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 930 Sw Abbey St, Newport, OR 97365 Phone: 541-265-2244 Fax: 541-574-1831
Dr. H. Joshua Carson, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 930 Sw Abbey St, Newport, OR 97365 Phone: 541-265-2244 Fax: 541-574-1831
Michael P Cruise, PA-C Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 705 Sw Coast Hwy, Newport, OR 97365 Phone: 541-574-4860
Reed S Epstein, DO Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 930 Sw Abbey St, Newport, OR 97365 Phone: 541-265-2244 Fax: 541-574-1831
Dr. Ashley W Forsyth, D.O. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1211 Sw Bay St, Unit B, Newport, OR 97365 Phone: 541-270-7146

Dr Audra Luz Kathleena Wisham, MD - Medicare Emergency Medicine in Newport, OR