Sarah Renee Wiederholt, MD is a medicare enrolled "Family Medicine" physician in St Joseph, Missouri. Her current practice location is
5210 North Belt Highway, St Joseph, Missouri. You can reach out to her office (for appointments etc.) via phone at
(816) 271-4971.
Sarah Renee Wiederholt is licensed to practice in Missouri (license number 2008003502) 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 1528161304.
Physician's Profile
| Full Name | Sarah Renee Wiederholt |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 5210 North Belt Highway, St Joseph, Missouri |
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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: 1528161304
- Provider Enumeration Date: 09/06/2006
- Last Update Date: 11/22/2017
Medicare PECOS Information:
- PECOS PAC ID: 9638249386
- Enrollment ID: I20080606000215
Medical Identifiers
Medical identifiers for Sarah Renee Wiederholt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528161304 | NPI | - | NPPES |
| P00628597 | Other | MO | RR MEDICARE |
| 200552180A | Medicaid | KS | |
| 1528161304 | Medicaid | MO | |
| 39921013 | Other | MO | BLUE CROSS BLUE SHIELD OF KANSAS CIITY |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | T2004018057 (Missouri) | Secondary |
| 207Q00000X | Family Medicine | 2008003502 (Missouri) | 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. Sarah Renee Wiederholt allows following entities to bill medicare on her behalf.
| Entity Name | Northwest Medical Center Association Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1124164322
PECOS PAC ID: 5496641896
Enrollment ID: O20040224000204 |
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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. Sarah Renee Wiederholt 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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Sarah Renee Wiederholt, MD
5210 North Belt Highway,
St Joseph, MO 64506-1211
Ph: (816) 271-4971 | Sarah Renee Wiederholt, MD
5210 North Belt Highway,
St Joseph, MO 64506-1211
Ph: (816) 271-4971 |
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