Dr Theodore Eugene Wyman, MD is a medicare enrolled "General Practice" physician in Banning, California. He went to Loma Linda University School Of Medicine and graduated in 2002 and has 22 years of diverse experience with area of expertise as Family Practice. His current practice location is
264 N Highland Springs Ave, Suite 5a, Banning, California. You can reach out to his office (for appointments etc.) via phone at
(951) 769-0079.
Dr Theodore Eugene Wyman is licensed to practice in California (license number A104884) 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 1083926919.
Physician's Profile
Full Name | Dr Theodore Eugene Wyman |
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Gender | Male |
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Speciality | Family Practice |
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Experience | 22 Years |
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Location | 264 N Highland Springs Ave, Banning, California |
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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. |
Medical Education and Training:
- Dr Theodore Eugene Wyman attended and graduated from Loma Linda University School Of Medicine in 2002
NPI Data:
- NPI Number: 1083926919
- Provider Enumeration Date: 07/08/2010
- Last Update Date: 04/13/2015
Medicare PECOS Information:
- PECOS PAC ID: 0345559571
- Enrollment ID: I20151028002831
Medical Identifiers
Medical identifiers for Dr Theodore Eugene Wyman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1083926919 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | A104884 (California) | 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 Theodore Eugene Wyman allows following entities to bill medicare on his behalf.
Entity Name | Neighborhood Healthcare |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1598703647 PECOS PAC ID: 5294649406 Enrollment ID: O20031112000809 |
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Entity Name | Emergency Medical Office, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1992723803 PECOS PAC ID: 1951358522 Enrollment ID: O20050405001442 |
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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 Theodore Eugene Wyman 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 Theodore Eugene Wyman, MD 264 N Highland Springs Ave, Suite 5a, Banning, CA 92220-3082 Ph: (951) 769-0079 | Dr Theodore Eugene Wyman, MD 264 N Highland Springs Ave, Suite 5a, Banning, CA 92220-3082 Ph: (951) 769-0079 |
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