Dr Johanna Lee Wickemeyer, MD is a medicare enrolled "Otolaryngology" physician in Berlin, Vermont. She went to Georgetown University School Of Medicine and graduated in 2017 and has 9 years of diverse experience with area of expertise as Otolaryngology. She is a member of the group practice Yale University and her current practice location is
130 Fisher Rd Ste 3-1, Berlin, Vermont. You can reach out to her office (for appointments etc.) via phone at
(802) 225-7025.
Dr Johanna Lee Wickemeyer is licensed to practice in Vermont (license number 042.0018725) 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 1902337033.
Physician's Profile
| Full Name | Dr Johanna Lee Wickemeyer |
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| Gender | Female |
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| Speciality | Otolaryngology |
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| Experience | 9 Years |
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| Location | 130 Fisher Rd Ste 3-1, Berlin, Vermont |
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| Accepts Medicare Assignments | Yes. She 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:
- Dr Johanna Lee Wickemeyer attended and graduated from Georgetown University School Of Medicine in 2017
NPI Data:
- NPI Number: 1902337033
- Provider Enumeration Date: 03/21/2017
- Last Update Date: 09/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 9436424751
- Enrollment ID: I20231026000982
Medical Identifiers
Medical identifiers for Dr Johanna Lee Wickemeyer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1902337033 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Y00000X | Otolaryngology | 042.0018725 (Vermont) | Primary |
| 207YS0012X | Otolaryngology - Sleep Medicine | 74545 (Connecticut) | Secondary |
| 207Y00000X | Otolaryngology | 74545 (Connecticut) | Secondary |
| 207YS0012X | Otolaryngology - Sleep Medicine | 042.0018725 (Vermont) | Secondary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Yale University | 9436061736 | 2389 |
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 Johanna Lee Wickemeyer allows following entities to bill medicare on her behalf.
| Entity Name | Yale University |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205822236
PECOS PAC ID: 9436061736
Enrollment ID: O20031105000015 |
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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 Johanna Lee Wickemeyer 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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Dr Johanna Lee Wickemeyer, MD
111 Colchester Ave,
Burlington, VT 05401-1473
Ph: (802) 847-0000 | Dr Johanna Lee Wickemeyer, MD
130 Fisher Rd Ste 3-1,
Berlin, VT 05602-9000
Ph: (802) 225-7025 |
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