Mark David Imwalle, MD in Fairfield, OH

Mark David Imwalle, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Fairfield, Ohio. His current practice location is 3000 Mack Rd, Fairfield, Ohio. You can reach out to his office (for appointments etc.) via phone at (513) 870-7024.

Mark David Imwalle is licensed to practice in Ohio (license number 35031812I) 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 1740284538.

Contact Information

	Mark David Imwalle, MD
	3000 Mack Rd, Fairfield, OH 45014-5335
	(513) 870-7024
	(513) 965-8091

Map and Direction

Physician's Profile

Full Name	Mark David Imwalle
Gender	Male
Speciality	Radiology - Diagnostic Radiology
Location	3000 Mack Rd, Fairfield, Ohio
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1740284538
Provider Enumeration Date: 06/09/2005
Last Update Date: 02/25/2008

Medicare PECOS Information:

PECOS PAC ID: 1759330319
Enrollment ID: I20050311000459

Medical Identifiers

Medical identifiers for Mark David Imwalle such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1740284538	NPI	-	NPPES
0349644	Medicaid	OH
64781099	Medicaid	KY

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2085R0202X	Radiology - Diagnostic Radiology	35031812I (Ohio)	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. Mark David Imwalle allows following entities to bill medicare on his behalf.

Entity Name	Proscan Radiology, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588654610 PECOS PAC ID: 5799680807 Enrollment ID: O20031203000127

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. Mark David Imwalle 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
Mark David Imwalle, MD Po Box 42417, Cincinnati, OH 45242-0417 Ph: (513) 965-8041	Mark David Imwalle, MD 3000 Mack Rd, Fairfield, OH 45014-5335 Ph: (513) 870-7024

Reviews and Comments

Radiology Doctors in Fairfield, OH

Dr. Michael A Cross, MD Radiology Medicare: Medicare Enrolled Practice Location: 2960 Mack Rd Ste 105, Fairfield, OH 45014 Phone: 513-751-2273 Fax: 513-751-1840
Bradford Harold Woodall, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091
Robert A Love Iii, MD Radiology Medicare: Medicare Enrolled Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091
Donald Kolman Imwalle, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-965-8041 Fax: 513-965-8091
Jeffrey I Grass, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2960 Mack Rd Ste 105, Fairfield, OH 45014 Phone: 513-751-2273
Susan Marie Cha, MD Radiology Medicare: Not Enrolled in Medicare Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091
Timothy Joseph Phalen, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3000 Mack Rd, Fairfield, OH 45014 Phone: 513-870-7024 Fax: 513-965-8091

Mark David Imwalle, MD - Medicare Radiology in Fairfield, OH