| Jill E Wiesenberger, DO | |
|
2333 Biddle St, Wyandotte, MI 48192-4668 | |
| (734) 246-7913 | |
| (734) 246-6968 |
| Full Name | Jill E Wiesenberger |
|---|---|
| Gender | Female |
| Speciality | Anesthesiology |
| Experience | 33 Years |
| Location | 2333 Biddle St, Wyandotte, Michigan |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215956743 | NPI | - | NPPES |
| 4088680-11 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207L00000X | Anesthesiology | 5101011882 (Michigan) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Henry Ford Wyandotte Hospital | Wyandotte, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Novi Aas Llc | 1557587847 | 7 |
| Northwestern Services Llc | 4486723657 | 40 |
| Metropolitan Anesthesia Consultants Pllc | 8921077249 | 27 |
| Entity Name | Metropolitan Anesthesia Consultants Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1386679868 PECOS PAC ID: 8921077249 Enrollment ID: O20041001000930 |
| Entity Name | Northwestern Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1215106679 PECOS PAC ID: 4486723657 Enrollment ID: O20080514000823 |
| Entity Name | Novi Aas Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598176919 PECOS PAC ID: 1557587847 Enrollment ID: O20140722002052 |
| Mailing Address | Practice Location Address |
|---|---|
| Jill E Wiesenberger, DO 2333 Biddle St, Wyandotte, MI 48192-4668 Ph: (734) 246-7913 | Jill E Wiesenberger, DO 2333 Biddle St, Wyandotte, MI 48192-4668 Ph: (734) 246-7913 |
Dr. Sonya Marie Elgammal, D.O. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 | |
Francis G Nazareno, M.D. Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle St, Wyandotte, MI 48192 Phone: 734-246-7913 Fax: 734-246-6968 | |
Charles Raymond, M.D. Anesthesiology Medicare: Not Enrolled in Medicare Practice Location: 2333 Biddle St, Wyandotte, MI 48192 Phone: 734-246-7913 Fax: 734-246-6968 | |
Mr. Gabriel L Alcodray, MD Anesthesiology Medicare: May Accept Medicare Assignments Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 | |
Jimmy Roger Boutin, M.D. Anesthesiology Medicare: Medicare Enrolled Practice Location: 2333 Biddle St, Wyandotte, MI 48192 Phone: 734-246-7913 Fax: 734-246-6968 | |
Timothy Lozon Jr., MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 2333 Biddle Ave, Wyandotte, MI 48192 Phone: 734-246-6000 |