Xiaoming Sun, MD is a medicare enrolled "Dermatology - Dermatopathology" physician in Pleasant Prairie, Wisconsin. Her current practice location is
11211 120th Ave Ste A009b, Pleasant Prairie, Wisconsin. You can reach out to her office (for appointments etc.) via phone at
(262) 283-5333.
Xiaoming Sun is licensed to practice in Wisconsin (license number 64617-20) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1265563761.
Physician's Profile
Full Name | Xiaoming Sun |
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Gender | Female |
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Speciality | Dermatology - Dermatopathology |
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Location | 11211 120th Ave Ste A009b, Pleasant Prairie, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1265563761
- Provider Enumeration Date: 03/08/2007
- Last Update Date: 11/08/2023
Medicare PECOS Information:
- PECOS PAC ID: 2860451036
- Enrollment ID: I20230803001349
Medical Identifiers
Medical identifiers for Xiaoming Sun such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1265563761 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ZD0900X | Pathology - Dermatopathology | 64617-20 (Wisconsin) | Secondary |
207ZP0101X | Pathology - Anatomic Pathology | 36108283 (Illinois) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 64617-20 (Wisconsin) | Secondary |
207ND0900X | Dermatology - Dermatopathology | 64617-20 (Wisconsin) | Primary |
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. Xiaoming Sun 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 |
Xiaoming Sun, MD 801 York St, Manitowoc, WI 54220-4630 Ph: (920) 663-9008 | Xiaoming Sun, MD 11211 120th Ave Ste A009b, Pleasant Prairie, WI 53158-1703 Ph: (262) 283-5333 |
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