Douglas C Dedelow, DO is a medicare enrolled "Obstetrics & Gynecology" physician in Hobart, Indiana. He went to Midwestern University, Chicago College Of Osteopathic Med and graduated in 1992 and has 32 years of diverse experience with area of expertise as Obstetrics/gynecology. He is a member of the group practice Community Care Network Inc and his current practice location is
1400 S Lake Park Ave, Ste 205, Hobart, Indiana. You can reach out to his office (for appointments etc.) via phone at
(219) 942-8620.
Douglas C Dedelow is licensed to practice in Indiana (license number 02001822A) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1861492993.
Physician's Profile
| Full Name | Douglas C Dedelow |
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| Gender | Male |
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| Speciality | Obstetrics/gynecology |
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| Experience | 32 Years |
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| Location | 1400 S Lake Park Ave, Hobart, Indiana |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Douglas C Dedelow attended and graduated from Midwestern University, Chicago College Of Osteopathic Med in 1992
NPI Data:
- NPI Number: 1861492993
- Provider Enumeration Date: 07/29/2005
- Last Update Date: 07/29/2010
Medicare PECOS Information:
- PECOS PAC ID: 3577633957
- Enrollment ID: I20080529000048
Medical Identifiers
Medical identifiers for Douglas C Dedelow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861492993 | NPI | - | NPPES |
| 200127880 | Medicaid | IN | |
| 256700A | Other | IN | MEDICARE PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207V00000X | Obstetrics & Gynecology | 02001822A (Indiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Community Care Network Inc | 3678737012 | 360 |
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 C Dedelow allows following entities to bill medicare on his behalf.
| Entity Name | Community Care Network Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457610487
PECOS PAC ID: 3678737012
Enrollment ID: O20120614000331 |
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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 C Dedelow 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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Douglas C Dedelow, DO
9660 Wicker Avenue,
St John, IN 46373-9487
Ph: (219) 226-2203 | Douglas C Dedelow, DO
1400 S Lake Park Ave, Ste 205,
Hobart, IN 46342-6790
Ph: (219) 942-8620 |
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