Dr Bernadette Maria Mandes Wildemore, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Dahlonega, Georgia. Her current practice location is
134 Ansley Dr Ste 500, Dahlonega, Georgia. You can reach out to her office (for appointments etc.) via phone at
(678) 853-2419.
Dr Bernadette Maria Mandes Wildemore is licensed to practice in Pennsylvania (license number MD430740) 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 1487863858.
Physician's Profile
Full Name | Dr Bernadette Maria Mandes Wildemore |
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Gender | Female |
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Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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Location | 134 Ansley Dr Ste 500, Dahlonega, Georgia |
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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: 1487863858
- Provider Enumeration Date: 05/22/2007
- Last Update Date: 06/20/2014
Medicare PECOS Information:
- PECOS PAC ID: 4183934961
- Enrollment ID: I20230908002512
Medical Identifiers
Medical identifiers for Dr Bernadette Maria Mandes Wildemore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1487863858 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | MD430740 (Pennsylvania) | Primary |
174400000X | Specialist | 2013-02274 (North Carolina) | Secondary |
174400000X | Specialist | 70607 (Georgia) | Secondary |
174400000X | Specialist | MD.33137 (Alabama) | Secondary |
174400000X | Specialist | MD430740 (Pennsylvania) | Secondary |
174400000X | Specialist | MD36443 (South Carolina) | Secondary |
174400000X | Specialist | 242668 (Massachusetts) | Secondary |
174400000X | Specialist | MD50706 (Tennessee) | Secondary |
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 Bernadette Maria Mandes Wildemore allows following entities to bill medicare on her behalf.
Entity Name | Mobility Health Llc |
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Entity Type | Part B Supplier - Independent Clinical Laboratory |
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Entity Identifiers | NPI Number: 1033724109 PECOS PAC ID: 5496168809 Enrollment ID: O20210104000931 |
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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. Dr Bernadette Maria Mandes Wildemore 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 Bernadette Maria Mandes Wildemore, MD 4405 Roseman Trl, Cumming, GA 30040-9367 Ph: (215) 609-7472 | Dr Bernadette Maria Mandes Wildemore, MD 134 Ansley Dr Ste 500, Dahlonega, GA 30533-1641 Ph: (678) 853-2419 |
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