Ahmet Dervish, MD in Green Bay, WI - Medicare Pain Medicine

Ahmet Dervish, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in Green Bay, Wisconsin. His current practice location is 2845 Greenbrier Rd Ste 340, Green Bay, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 288-8380.

Ahmet Dervish is licensed to practice in Wisconsin (license number 33794) 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 1104854462.

Contact Information

	Ahmet Dervish, MD
	2845 Greenbrier Rd Ste 340, Green Bay, WI 54311-6519
	(920) 288-8380
	(920) 288-8385

Map and Direction

Physician's Profile

Full Name	Ahmet Dervish
Gender	Male
Speciality	Pain Medicine - Interventional Pain Medicine
Location	2845 Greenbrier Rd Ste 340, Green Bay, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1104854462
Provider Enumeration Date: 06/28/2006
Last Update Date: 08/29/2008

Medicare PECOS Information:

PECOS PAC ID: 9537055355
Enrollment ID: I20040708000919

Medical Identifiers

Medical identifiers for Ahmet Dervish such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104854462	NPI	-	NPPES
104365449	Medicaid	MI
050080452	Other	WI	RAILROAD
32021400	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208VP0014X	Pain Medicine - Interventional Pain Medicine	33794 (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. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ahmet Dervish allows following entities to bill medicare on his behalf.

Entity Name	Baycare Clinic Llp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588609648 PECOS PAC ID: 4385554328 Enrollment ID: O20031105000087

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. Ahmet Dervish 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
Ahmet Dervish, MD 2845 Greenbrier Rd Ste 340, Po Box 8900, Green Bay, WI 54308-8900 Ph: (920) 288-8380	Ahmet Dervish, MD 2845 Greenbrier Rd Ste 340, Green Bay, WI 54311-6519 Ph: (920) 288-8380

Reviews and Comments

Pain Medicine Doctors in Green Bay, WI

Timothy R Cooper, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 2845 Greenbrier Rd, Green Bay, WI 54311 Phone: 877-229-0273 Fax: 920-288-4863
Dr. Reginald E Julien, M.D. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 835 S Van Buren St, Green Bay, WI 54301 Phone: 920-433-0111
Dr. Ajeet Sharma, MD Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 835 S Van Buren St, Green Bay, WI 54301 Phone: 844-276-5853 Fax: 262-439-7674
Dr. Amy C. Yeatman, D.O. Pain Medicine Medicare: Accepting Medicare Assignments Practice Location: 744 S Webster Ave, Green Bay, WI 54301 Phone: 920-431-5607

Ahmet Dervish, MD - Medicare Pain Medicine in Green Bay, WI