Marc Luther Wilcox, MS CCC-A is a medicare enrolled "Audiologist" provider in Fredonia, New York. His current practice location is
280 Central Ave, W123 Thompson Hall, Fredonia, New York. You can reach out to his office (for appointments etc.) via phone at
(716) 673-3203.
Marc Luther Wilcox is licensed to practice in New York (license number 001310-1) 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 1205855145.
Healthcare Provider's Profile
| Full Name | Marc Luther Wilcox |
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| Gender | Male |
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| Speciality | Audiologist |
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| Location | 280 Central Ave, Fredonia, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1205855145
- Provider Enumeration Date: 07/19/2006
- Last Update Date: 02/20/2013
Medicare PECOS Information:
- PECOS PAC ID: 1759377344
- Enrollment ID: I20040421000149
Medical Identifiers
Medical identifiers for Marc Luther Wilcox such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1205855145 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 231H00000X | Audiologist | 001310-1 (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. Marc Luther Wilcox allows following entities to bill medicare on his behalf.
| Provider Name | State Of New York Comptrollers Office |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1508079567
PECOS PAC ID: 0840101770
Enrollment ID: O20040304000126 |
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| Provider Name | Diversified Services For Occupational Therapy Physical Ther |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1447283882
PECOS PAC ID: 0143204917
Enrollment ID: O20050805000553 |
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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. Marc Luther Wilcox 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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Marc Luther Wilcox, MS CCC-A
280 Central Ave, W123 Thompson Hall,
Fredonia, NY 14063-1127
Ph: (716) 673-3203 | Marc Luther Wilcox, MS CCC-A
280 Central Ave, W123 Thompson Hall,
Fredonia, NY 14063-1127
Ph: (716) 673-3203 |
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