Douglas Adolph Mazurek, MD is a medicare enrolled "Specialist" physician in Valparaiso, Indiana. His current practice location is
1101 Glendale Blvd, Suite 103, Valparaiso, Indiana. You can reach out to his office (for appointments etc.) via phone at
(219) 464-9054.
Douglas Adolph Mazurek is licensed to practice in Indiana (license number 01038566A) 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 1033223235.
Physician's Profile
| Full Name | Douglas Adolph Mazurek |
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| Gender | Male |
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| Speciality | Specialist |
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| Location | 1101 Glendale Blvd, Valparaiso, Indiana |
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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: 1033223235
- Provider Enumeration Date: 08/18/2006
- Last Update Date: 09/11/2020
Medicare PECOS Information:
- PECOS PAC ID: 7012953383
- Enrollment ID: I20081120000417
Medical Identifiers
Medical identifiers for Douglas Adolph Mazurek such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1033223235 | NPI | - | NPPES |
| 200016720 | Medicaid | IN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207RC0200X | Internal Medicine - Critical Care Medicine | 01038566 (Indiana) | Secondary |
| 207RP1001X | Internal Medicine - Pulmonary Disease | 01038566 (Indiana) | Secondary |
| 174400000X | Specialist | 01038566A (Indiana) | 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. Douglas Adolph Mazurek allows following entities to bill medicare on his behalf.
| Entity Name | Porter Physician Services Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1508075680 PECOS PAC ID: 1850482407 Enrollment ID: O20070810000409 |
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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. Douglas Adolph Mazurek 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 |
Douglas Adolph Mazurek, MD 2022 Kelle Dr, Chesterton, IN 46304-8708 Ph: (219) 364-3616 | Douglas Adolph Mazurek, MD 1101 Glendale Blvd, Suite 103, Valparaiso, IN 46383-3767 Ph: (219) 464-9054 |
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