Emily Louise Wickersham, DO - Medicare Pathology in Bolivar, MO

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Emily Louise Wickersham, DO is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Bolivar, Missouri. She graduated from medical school in 2020 and has 6 years of diverse experience with area of expertise as Pathology. She is a member of the group practice Citizens Memorial Hospital District and her current practice location is 1500 N Oakland Ave, Bolivar, Missouri. You can reach out to her office (for appointments etc.) via phone at (417) 326-6000.

Emily Louise Wickersham is licensed to practice in Missouri (license number 2024028249) 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 1093175358.

Contact Information

Emily Louise Wickersham, DO
1500 N Oakland Ave,
Bolivar, MO 65613-3099
(417) 326-6000
Not Available

Map and Direction




Physician's Profile

Full NameEmily Louise Wickersham
GenderFemale
SpecialityPathology
Experience6 Years
Location1500 N Oakland Ave, Bolivar, Missouri
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Emily Louise Wickersham graduated from medical school in 2020
  NPI Data:
  • NPI Number: 1093175358
  • Provider Enumeration Date: 02/29/2016
  • Last Update Date: 01/15/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 0143755124
  • Enrollment ID: I20241127003054

Medical Identifiers

Medical identifiers for Emily Louise Wickersham such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1093175358NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207ZP0102XPathology - Anatomic Pathology & Clinical Pathology 036.177695 (Illinois)Secondary
207ZP0102XPathology - Anatomic Pathology & Clinical Pathology 2024028249 (Missouri)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Citizens Memorial HospitalBolivar, MOHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Citizens Memorial Hospital District276957443333

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. Emily Louise Wickersham allows following entities to bill medicare on her behalf.
Entity NameCitizens Memorial Hospital District
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1558548818
PECOS PAC ID: 2769574433
Enrollment ID: O20070827000044

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. Emily Louise Wickersham 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 AddressPractice Location Address
Emily Louise Wickersham, DO
19135 Pawnee Ct,
Saint Joseph, MO 64505-8901

Ph: (309) 258-5813		Emily Louise Wickersham, DO
1500 N Oakland Ave,
Bolivar, MO 65613-3099

Ph: (417) 326-6000

Reviews and Comments


Pathology Doctors in Bolivar, MO

Christina Otterness, DO
Pathology
Medicare: Accepting Medicare Assignments
Practice Location: 1500 N Oakland Ave, Bolivar, MO 65613
Phone: 417-328-6036    Fax: 417-328-6039

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.