Wanda Averhart, MD is a medicare enrolled "Pediatrics" physician in Lake Station, Indiana. Her current practice location is
2490 Central Ave, Lake Station, Indiana. You can reach out to her office (for appointments etc.) via phone at
(216) 764-5399.
Wanda Averhart is licensed to practice in Indiana (license number 01088252A) 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 1598184632.
Physician's Profile
| Full Name | Wanda Averhart |
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| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 2490 Central Ave, Lake Station, Indiana |
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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: 1598184632
- Provider Enumeration Date: 04/15/2014
- Last Update Date: 08/31/2022
Medicare PECOS Information:
- PECOS PAC ID: 0345542403
- Enrollment ID: I20220829000245
Medical Identifiers
Medical identifiers for Wanda Averhart such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1598184632 | NPI | - | NPPES |
| 05412419 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 208000000X | Pediatrics | 01088252A (Indiana) | 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. Wanda Averhart allows following entities to bill medicare on her behalf.
| Entity Name | Northshore Health Centers Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1114257300 PECOS PAC ID: 5799671236 Enrollment ID: O20040827000220 |
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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. Wanda Averhart 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 |
Wanda Averhart, MD 2490 Central Ave, Lake Station, IN 46405-2122 Ph: (216) 764-5399 | Wanda Averhart, MD 2490 Central Ave, Lake Station, IN 46405-2122 Ph: (216) 764-5399 |
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