Dr Agnes Prospere, MD in Oak Creek, WI - Medicare Family Medicine

Dr Agnes Prospere, MD is a medicare enrolled "Family Medicine" physician in Oak Creek, Wisconsin. Her current practice location is 200 E Ryan Rd, Oak Creek, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (414) 570-3590.

Dr Agnes Prospere is licensed to practice in Wisconsin (license number 80102-20) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1083241301.

Contact Information

	Dr Agnes Prospere, MD
	200 E Ryan Rd, Oak Creek, WI 53154-4563
	(414) 570-3590
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Agnes Prospere
Gender	Female
Speciality	Family Medicine
Location	200 E Ryan Rd, Oak Creek, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1083241301
Provider Enumeration Date: 03/25/2020
Last Update Date: 10/26/2023

Medicare PECOS Information:

PECOS PAC ID: 0749665008
Enrollment ID: I20230920001322

Medical Identifiers

Medical identifiers for Dr Agnes Prospere such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1083241301	NPI	-	NPPES
100213444	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	80102-20 (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. Dr Agnes Prospere allows following entities to bill medicare on her behalf.

Entity Name	Lakeshore Medical Clinic Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003861188 PECOS PAC ID: 7719890730 Enrollment ID: O20031106000481

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. Dr Agnes Prospere 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
Dr Agnes Prospere, MD Po Box 735044, Chicago, IL 60673-4329 Ph: (414) 570-3590	Dr Agnes Prospere, MD 200 E Ryan Rd, Oak Creek, WI 53154-4563 Ph: (414) 570-3590

Reviews and Comments

Family Medicine Doctors in Oak Creek, WI

Shereen Mohis, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 200 E Ryan Rd, Oak Creek, WI 53154 Phone: 414-570-3590
Lakesha Luckett, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 2330 E Chestnut Dr, Oak Creek, WI 53154 Phone: 414-397-2528
Kandipati Sreenivasarao, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 S 6th St, Oak Creek, WI 53154 Phone: 414-346-8000
Dr. Jessica Lynn Woznick, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 S 6th St, Oak Creek, WI 53154 Phone: 414-346-8000 Fax: 414-346-8010
Andrew Brayer, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 7901 S 6th St, Oak Creek, WI 53154 Phone: 414-346-8000 Fax: 414-346-8010
Heather Butler, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 8020 S Howell Ave, Oak Creek, WI 53154 Phone: 414-647-3920

Dr Agnes Prospere, MD - Medicare Family Medicine in Oak Creek, WI