Carl Thayne Wilson, MD in Provo, UT - Medicare Anesthesiology

Carl Thayne Wilson, MD is a medicare enrolled "Anesthesiology" physician in Provo, Utah. His current practice location is 1034 North 500 West, Utah Valley Regional Medical Center, Provo, Utah. You can reach out to his office (for appointments etc.) via phone at (801) 507-5248.

Carl Thayne Wilson is licensed to practice in Utah (license number 88-179937-1205) 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 1073608659.

Contact Information

	Carl Thayne Wilson, MD
	1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604
	(801) 507-5248
	(801) 733-5618

Map and Direction

Physician's Profile

Full Name	Carl Thayne Wilson
Gender	Male
Speciality	Anesthesiology
Location	1034 North 500 West, Provo, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1073608659
Provider Enumeration Date: 10/03/2006
Last Update Date: 10/15/2012

Medicare PECOS Information:

PECOS PAC ID: 4183803299
Enrollment ID: I20110121000209

Medical Identifiers

Medical identifiers for Carl Thayne Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1073608659	NPI	-	NPPES
2090168	Other	UT	UNITED HEALTHCARE
768046	Medicaid	AZ
37038	Other	UT	DESERET MUTUAL
806095300	Medicaid	ID
8597445	Other	UT	WORKERS COMP
1502954	Other	UT	UMWA
37831	Other	UT	PEHP
870545614WI1	Other	UT	EDUCATORS MUTUAL
TPRA07712	Other	UT	MOLINA
QM0000075886	Other	UT	ALTIUS
107005544101	Other	UT	IHC
119214100	Medicaid	WY
53282	Other	UT	HEALTHY U
002089788	Medicaid	NV

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207L00000X	Anesthesiology	88-179937-1205 (Utah)	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. Carl Thayne Wilson allows following entities to bill medicare on his behalf.

Entity Name	Mountain West Anesthesia Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1558391763 PECOS PAC ID: 9032018502 Enrollment ID: O20040103000057

Entity Name	Family Surgical Suite
Entity Type	Part B Supplier - Ambulatory Surgical Center
Entity Identifiers	NPI Number: 1508040221 PECOS PAC ID: 6901989003 Enrollment ID: O20080213000228

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. Carl Thayne Wilson 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
Carl Thayne Wilson, MD 3340 North Center St, #800, Lehi, UT 84043-7406 Ph: (801) 990-1911	Carl Thayne Wilson, MD 1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604 Ph: (801) 507-5248

Reviews and Comments

Anesthesiology Doctors in Provo, UT

Dr. Daniel Rey Faber, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 280 River Park Dr, #200, Provo, UT 84604 Phone: 801-223-4860 Fax: 801-371-8993
John B Zimmerman, MD Anesthesiology Medicare: Medicare Enrolled Practice Location: 1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604 Phone: 801-507-5248 Fax: 801-733-5618
David Groesbeck, MD Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 1034 North 500 West, Utah Valley Regional Medical Center, Provo, UT 84604 Phone: 801-507-5248 Fax: 801-733-5618
Jeffrey David Poulsen, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7850
Mr. Matthew David Wagaman, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84604 Phone: 801-357-7850 Fax: 770-701-6675
Mitchell D Albrecht, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1034 N 500 W, Provo, UT 84004 Phone: 801-993-9582 Fax: 801-733-5618

Carl Thayne Wilson, MD - Medicare Anesthesiology in Provo, UT