Lola Mudgistratova Wise, MD in Renton, WA - Medicare Emergency Medicine

Lola Mudgistratova Wise, MD is a medicare enrolled "Emergency Medicine" physician in Renton, Washington. She went to University Of Washington School Of Medicine and graduated in 2017 and has 8 years of diverse experience with area of expertise as Emergency Medicine. She is a member of the group practice Associated Emergency Room Physicians Inc Ps and her current practice location is 400 S 43rd St, Renton, Washington. You can reach out to her office (for appointments etc.) via phone at (206) 661-2563.

Lola Mudgistratova Wise is licensed to practice in Washington (license number MD60963016) 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 1609309533.

Contact Information

	Lola Mudgistratova Wise, MD
	400 S 43rd St, Renton, WA 98055-5714
	(206) 661-2563
	Not Available

Map and Direction

Physician's Profile

Full Name	Lola Mudgistratova Wise
Gender	Female
Speciality	Emergency Medicine
Experience	8 Years
Location	400 S 43rd St, Renton, Washington
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Lola Mudgistratova Wise attended and graduated from University Of Washington School Of Medicine in 2017

NPI Data:

NPI Number: 1609309533
Provider Enumeration Date: 04/07/2017
Last Update Date: 01/31/2025

Medicare PECOS Information:

PECOS PAC ID: 2163790312
Enrollment ID: I20200713000307

Medical Identifiers

Medical identifiers for Lola Mudgistratova Wise such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1609309533	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	MD60963016 (Washington)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Valley Medical Center	Renton, WA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Associated Emergency Room Physicians Inc Ps	7911892054	27

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. Lola Mudgistratova Wise allows following entities to bill medicare on her behalf.

Entity Name	Kaiser Foundation Health Plan Of Washington
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396810701 PECOS PAC ID: 9032022579 Enrollment ID: O20031112000454

Entity Name	Associated Emergency Room Physicians Inc Ps
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861480840 PECOS PAC ID: 7911892054 Enrollment ID: O20040218000447

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. Lola Mudgistratova Wise 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
Lola Mudgistratova Wise, MD 3321 104th Pl Se, Everett, WA 98208-4538 Ph: (206) 661-2563	Lola Mudgistratova Wise, MD 400 S 43rd St, Renton, WA 98055-5714 Ph: (206) 661-2563

Reviews and Comments

Emergency Medicine Doctors in Renton, WA

Peter R. Schmidt, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 S 43rd St, Er Dept, Renton, WA 98055 Phone: 425-228-3450
Karl H Kaufmann, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 S 43rd St, Er Dept, Renton, WA 98055 Phone: 425-228-3450
Stephen William Bretz, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 S 43rd St, Er Dept, Renton, WA 98055 Phone: 425-251-3440
Riley Anne Fisher, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 606 Oakesdale Ave Sw Ste C200, Renton, WA 98057 Phone: 866-259-1629
Paul Alfred Lee, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 400 S 43rd St, Emergency Department, Renton, WA 98055 Phone: 425-228-3440 Fax: 425-656-5016
Gabrielle Dionyse Lauren Bernard, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1205 N 10th St Ste A, Renton, WA 98057 Phone: 425-690-3475 Fax: 425-690-9475
Larry J Kadeg, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 400 S 43rd St, Er Dept, Renton, WA 98055 Phone: 425-228-3450

Lola Mudgistratova Wise, MD - Medicare Emergency Medicine in Renton, WA