Dr Jeannine Marie Fortin, MD in Seymour, WI

Dr Jeannine Marie Fortin, MD is a medicare enrolled "Family Medicine" physician in Seymour, Wisconsin. She went to University Of Manitoba, Faculty Of Medicine and graduated in 1985 and has 41 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Cleanslate Medical Group Of Wisconsin Sc and her current practice location is 1100 Orchard Dr, Seymour, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 833-5100.

Dr Jeannine Marie Fortin is licensed to practice in Wisconsin (license number 46699) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1174556450.

Contact Information

	Dr Jeannine Marie Fortin, MD
	1100 Orchard Dr, Seymour, WI 54165-1600
	(920) 833-5100
	(920) 833-5100

Map and Direction

Physician's Profile

Full Name	Dr Jeannine Marie Fortin
Gender	Female
Speciality	Family Practice
Experience	41 Years
Location	1100 Orchard Dr, Seymour, Wisconsin
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Jeannine Marie Fortin attended and graduated from University Of Manitoba, Faculty Of Medicine in 1985

NPI Data:

NPI Number: 1174556450
Provider Enumeration Date: 07/09/2006
Last Update Date: 09/11/2012

Medicare PECOS Information:

PECOS PAC ID: 5799768727
Enrollment ID: I20040823001319

Medical Identifiers

Medical identifiers for Dr Jeannine Marie Fortin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1174556450	NPI	-	NPPES
34533800	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	46699 (Wisconsin)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Cleanslate Medical Group Of Wisconsin Sc	4284905134	25

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 Jeannine Marie Fortin allows following entities to bill medicare on her behalf.

Entity Name	Vohra Wound Physicians Of The Mid-west, S.c.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720536477 PECOS PAC ID: 9739467309 Enrollment ID: O20161102001017

Entity Name	Cleanslate Medical Group Of Wisconsin Sc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518404854 PECOS PAC ID: 4284905134 Enrollment ID: O20170810002045

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 Jeannine Marie Fortin 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 Jeannine Marie Fortin, MD 1100 Orchard Dr, Seymour, WI 54165-1600 Ph: (920) 833-5100	Dr Jeannine Marie Fortin, MD 1100 Orchard Dr, Seymour, WI 54165-1600 Ph: (920) 833-5100

Reviews and Comments

Family Medicine Doctors in Seymour, WI

Steven D Turzinski, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 958 Foote St, Seymour, WI 54165 Phone: 920-496-4700 Fax: 920-833-7605
Stephanie L Alban, NP Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 958 Foote St, Seymour, WI 54165 Phone: 920-833-9896
Christopher Z Watson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 405 Commercial St, Seymour, WI 54165 Phone: 920-833-2318 Fax: 920-833-6883

Dr Jeannine Marie Fortin, MD - Medicare Family Practice in Seymour, WI