Jay M Miesfeld, MD is a medicare enrolled "Pediatrics" physician in Beaver Dam, Wisconsin. His current practice location is
109 Warren St Ste 4, Beaver Dam, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(920) 885-3305.
Jay M Miesfeld is licensed to practice in Wisconsin (license number 54813-20) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1437354602.
Physician's Profile
| Full Name | Jay M Miesfeld |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 109 Warren St Ste 4, Beaver Dam, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1437354602
- Provider Enumeration Date: 06/18/2007
- Last Update Date: 10/26/2011
Medicare PECOS Information:
- PECOS PAC ID: 6800089483
- Enrollment ID: I20101015000744
Medical Identifiers
Medical identifiers for Jay M Miesfeld such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1437354602 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | R-8095 (Iowa) | Secondary |
| 208000000X | Pediatrics | 54813-20 (Wisconsin) | 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. Jay M Miesfeld allows following entities to bill medicare on his behalf.
| Entity Name | Community Pediatrics Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1275749566
PECOS PAC ID: 8729015409
Enrollment ID: O20050725000693 |
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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. Jay M Miesfeld 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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Jay M Miesfeld, MD
711 Avalon Rd,
Columbus, WI 53925-2304
Ph: (608) 444-8025 | Jay M Miesfeld, MD
109 Warren St Ste 4,
Beaver Dam, WI 53916-3082
Ph: (920) 885-3305 |
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