Maryanne Wilson, is a medicare enrolled "Physical Therapist" physician in Renton, Washington. Her current practice location is
17800 Talbot Rd S Ste D, Renton, Washington. You can reach out to her office (for appointments etc.) via phone at
(425) 277-9096.
Maryanne Wilson is licensed to practice in Washington (license number PT70017178) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1508567090.
Physician's Profile
Full Name | Maryanne Wilson |
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Gender | Female |
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Speciality | Physical Therapist |
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Location | 17800 Talbot Rd S Ste D, Renton, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1508567090
- Provider Enumeration Date: 03/13/2023
- Last Update Date: 06/30/2025
Medicare PECOS Information:
- PECOS PAC ID: 0446614937
- Enrollment ID: I20230918000920
Medical Identifiers
Medical identifiers for Maryanne Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508567090 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208100000X | Physical Medicine & Rehabilitation | 0018952 (Colorado) | Secondary |
225100000X | Physical Therapist | PT70017178 (Washington) | 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. Maryanne Wilson allows following entities to bill medicare on her behalf.
Entity Name | Intermountain Medical Group Denver, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1083021083 PECOS PAC ID: 0840513552 Enrollment ID: O20150106000131 |
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Entity Name | Colorado Luna Care Physical Therapy Llc |
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Entity Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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Entity Identifiers | NPI Number: 1891461125 PECOS PAC ID: 7517363617 Enrollment ID: O20210914002694 |
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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. Maryanne Wilson 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 |
Maryanne Wilson, 2001 Butterfield Rd Ste 1600, Downers Grove, IL 60515-1211 Ph: () - | Maryanne Wilson, 17800 Talbot Rd S Ste D, Renton, WA 98055-5740 Ph: (425) 277-9096 |
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