Andrea Jo Poulson-port, MD in Manitowoc, WI

Andrea Jo Poulson-port, MD is a medicare enrolled "Family Medicine" physician in Manitowoc, Wisconsin. She went to Wayne State University School Of Medicine and graduated in 2009 and has 16 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Aamg Reach Pllc, Aurora Medical Group, Inc. and her current practice location is 4100 Dewey St, Manitowoc, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 686-5700.

Andrea Jo Poulson-port is licensed to practice in Wisconsin (license number 56118-20) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1326280611.

Contact Information

	Andrea Jo Poulson-port, MD
	4100 Dewey St, Manitowoc, WI 54220-5497
	(920) 686-5700
	Not Available

Map and Direction

Physician's Profile

Full Name	Andrea Jo Poulson-port
Gender	Female
Speciality	Family Practice
Experience	16 Years
Location	4100 Dewey St, Manitowoc, Wisconsin
Accepts Medicare Assignments	May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Andrea Jo Poulson-port attended and graduated from Wayne State University School Of Medicine in 2009

NPI Data:

NPI Number: 1326280611
Provider Enumeration Date: 04/01/2009
Last Update Date: 09/24/2024

Medicare PECOS Information:

PECOS PAC ID: 8820247299
Enrollment ID: I20120927000853

Medical Identifiers

Medical identifiers for Andrea Jo Poulson-port such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1326280611	NPI	-	NPPES
100024879	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	56118-20 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Aurora At Home	Green bay, WI	Home health agency
Aurora Medical Ctr Manitowoc County	Two rivers, WI	Hospital
Holy Family Memorial	Manitowoc, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Aamg Reach Pllc	5597133264	54
Aurora Medical Group, Inc.	6709794258	3491

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. Andrea Jo Poulson-port allows following entities to bill medicare on her behalf.

Entity Name	Aurora Medical Group, Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725

Entity Name	Aamg Reach Pllc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1609502707 PECOS PAC ID: 5597133264 Enrollment ID: O20221216002458

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. Andrea Jo Poulson-port 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
Andrea Jo Poulson-port, MD Po Box 735044, Chicago, IL 60673-5044 Ph: (800) 326-2250	Andrea Jo Poulson-port, MD 4100 Dewey St, Manitowoc, WI 54220-5497 Ph: (920) 686-5700

Reviews and Comments

Family Medicine Doctors in Manitowoc, WI

Dr. Michael Herbert Hoffman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3415 Custer St, Suite D, Manitowoc, WI 54220 Phone: 920-652-9310
Michael P Tapscott, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 4810 Expo Dr, Manitowoc, WI 54220 Phone: 920-717-0800
Bryan J Mulheron, D.O. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 3509 Dewey St, Manitowoc, WI 54220 Phone: 920-686-5731
Laurence J Verlinden, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-4500 Fax: 920-682-9378
Patricia J Cantagallo, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 601 Reed Ave, Manitowoc, WI 54220 Phone: 920-682-8841
Gary A Schmidt, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1650 S 41st St, Manitowoc, WI 54220 Phone: 920-320-4500 Fax: 920-682-9378
Dr. Diane L Staudinger, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 3509 Dewey St, Manitowoc, WI 54220 Phone: 920-686-5731 Fax: 920-686-5726

Andrea Jo Poulson-port, MD - Medicare Family Practice in Manitowoc, WI