Nicholas James Waldvogel, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Ann Arbor, Michigan. His current practice location is
1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, Michigan. You can reach out to his office (for appointments etc.) via phone at
(734) 764-6879.
Nicholas James Waldvogel is licensed to practice in Michigan (license number 4351050782) 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 1467035907.
Physician's Profile
| Full Name | Nicholas James Waldvogel |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 1500 E Medical Center Drive, Uh South F-6245, Ann Arbor, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1467035907
- Provider Enumeration Date: 05/03/2021
- Last Update Date: 11/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 0547627978
- Enrollment ID: I20250623000499
Medical Identifiers
Medical identifiers for Nicholas James Waldvogel such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1467035907 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301512691 (Michigan) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | 4351050782 (Michigan) | 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. Nicholas James Waldvogel allows following entities to bill medicare on his behalf.
| Entity Name | Bronson-acadia Joint Venture LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1083337372
PECOS PAC ID: 4688031578
Enrollment ID: O20230713003631 |
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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. Nicholas James Waldvogel 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 |
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Nicholas James Waldvogel,
600 S Paulina St Ste 403,
Chicago, IL 60612-3806
Ph: Not Available | Nicholas James Waldvogel,
1500 E Medical Center Drive, Uh South F-6245,
Ann Arbor, MI 48109
Ph: (734) 764-6879 |
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