Dr Wantzy Cooper, DO is a medicare enrolled "Surgery - Vascular Surgery" physician in Needles, California. She went to College Of Osteo Med Of The Pacific At Pomona and graduated in 1996 and has 28 years of diverse experience with area of expertise as Vascular Surgery. She is a member of the group practice Community Healthcare Partner, Inc and her current practice location is
1401 Bailey Ave, Bldg 1, Needles, California. You can reach out to her office (for appointments etc.) via phone at
(760) 590-0155.
Dr Wantzy Cooper is licensed to practice in Arizona (license number 005530) 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 1942383393.
Physician's Profile
| Full Name | Dr Wantzy Cooper |
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| Gender | Female |
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| Speciality | Vascular Surgery |
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| Experience | 28 Years |
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| Location | 1401 Bailey Ave, Needles, California |
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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:
- Dr Wantzy Cooper attended and graduated from College Of Osteo Med Of The Pacific At Pomona in 1996
NPI Data:
- NPI Number: 1942383393
- Provider Enumeration Date: 10/21/2006
- Last Update Date: 04/08/2024
Medicare PECOS Information:
- PECOS PAC ID: 6002815214
- Enrollment ID: I20110208000789
Medical Identifiers
Medical identifiers for Dr Wantzy Cooper such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1942383393 | NPI | - | NPPES |
| 585877 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 14611 (California) | Secondary |
| 208600000X | Surgery | MB74255 (New Jersey) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 14611 (California) | Secondary |
| 208D00000X | General Practice | 14611 (California) | Secondary |
| 208D00000X | General Practice | 005530 (Arizona) | Secondary |
| 2086S0129X | Surgery - Vascular Surgery | 005530 (Arizona) | Primary |
Medical Facilities Affiliation
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 Wantzy Cooper allows following entities to bill medicare on her behalf.
| Entity Name | Tri-state Vascular Group Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366993818
PECOS PAC ID: 5395026827
Enrollment ID: O20161221001174 |
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| Entity Name | Colorado River Primary Care Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1669146536
PECOS PAC ID: 2668863200
Enrollment ID: O20240227004341 |
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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. Dr Wantzy Cooper 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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Dr Wantzy Cooper, DO
Po Box 9893,
Fort Mohave, AZ 86427-9893
Ph: (760) 590-0155 | Dr Wantzy Cooper, DO
1401 Bailey Ave, Bldg 1,
Needles, CA 92363-3103
Ph: (760) 590-0155 |
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