Michael Lynn Fetterolf, MD in New London, WI

Michael Lynn Fetterolf, MD is a medicare enrolled "Family Medicine" physician in New London, Wisconsin. His current practice location is 1405 Mill St, New London, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 531-2400.

Michael Lynn Fetterolf is licensed to practice in Wisconsin (license number 55231-20) 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 1821069691.

Contact Information

	Michael Lynn Fetterolf, MD
	1405 Mill St, New London, WI 54961-2155
	(920) 531-2400
	Not Available

Map and Direction

Physician's Profile

Full Name	Michael Lynn Fetterolf
Gender	Male
Speciality	Family Medicine
Location	1405 Mill St, New London, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1821069691
Provider Enumeration Date: 01/30/2006
Last Update Date: 12/11/2020

Medicare PECOS Information:

PECOS PAC ID: 3779523030
Enrollment ID: I20110321000310

Medical Identifiers

Medical identifiers for Michael Lynn Fetterolf such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1821069691	NPI	-	NPPES
0010419750001	Medicaid	PA
450030702	Other	WI	MEDICARE PTAN
160011217	Other	PA	RAILROAD MEDICARE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	MD031976E (Pennsylvania)	Secondary
207VX0000X	Obstetrics & Gynecology - Obstetrics	MD031976E (Pennsylvania)	Secondary
207Q00000X	Family Medicine	55231-20 (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. Michael Lynn Fetterolf allows following entities to bill medicare on his behalf.

Entity Name	Ascension Medical Group-fox Valley Wisconsin Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1730126392 PECOS PAC ID: 0244142420 Enrollment ID: O20031105000351

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. Michael Lynn Fetterolf 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
Michael Lynn Fetterolf, MD Po Box 8003, Appleton, WI 54912-8003 Ph: (920) 996-3200	Michael Lynn Fetterolf, MD 1405 Mill St, New London, WI 54961-2155 Ph: (920) 531-2400

Reviews and Comments

Family Medicine Doctors in New London, WI

Donn Fuhrmann, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2400 Fax: 920-531-2450
Karly Lynn Johannsen, Family Medicine Medicare: Medicare Enrolled Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2400 Fax: 920-531-2404
Timothy Houlihan, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2400 Fax: 920-531-2450
Renae Schuler, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2400 Fax: 920-531-2450
Reginald A Ebirim, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2000 Fax: 920-531-2098
Felix Jolly Odathil, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1405 Mill St, New London, WI 54961 Phone: 920-531-2000 Fax: 920-531-2450
Dale L Schlais, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1420 Algoma St, New London, WI 54961 Phone: 920-982-8300

Michael Lynn Fetterolf, MD - Medicare Family Medicine in New London, WI