Peninsula Podiatry Llc is a medicare enrolled "Podiatrist" provider in Sturgeon Bay, Wisconsin. Their current practice location is
Bldg 4 2, 30 North 18th Avenue, Sturgeon Bay, Wisconsin. You can reach out to their office (for appointments etc.) via phone at
(920) 743-6668.
Peninsula Podiatry Llc is licensed to practice in Wisconsin (license number ) and it also participates in the medicare program. Peninsula Podiatry Llc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1255425088.
Healthcare Provider's Profile
| Full Name | Peninsula Podiatry Llc |
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| Type | Facility |
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| Speciality | Podiatrist |
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| Location | Bldg 4 2, Sturgeon Bay, Wisconsin |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1255425088
- Provider Enumeration Date: 10/03/2006
- Last Update Date: 02/05/2008
Medicare PECOS Information:
- PECOS PAC ID: 0244280329
- Enrollment ID: O20050126000762
Medical Identifiers
Medical identifiers for Peninsula Podiatry Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255425088 | NPI | - | NPPES |
| 43267300 | Medicaid | WI | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213E00000X | Podiatrist | (Wisconsin) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | (Wisconsin) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Peninsula Podiatry Llc acts as a billing entity for following providers:
| Provider Name | Bradley Gerard Burkart |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1528281862
PECOS PAC ID: 5597715672
Enrollment ID: I20050127000285 |
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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. Peninsula Podiatry Llc 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 |
|---|
Peninsula Podiatry Llc
Bldg 4 2, 30 North 18th Avenue,
Sturgeon Bay, WI 54235-3207
Ph: (920) 743-6668 | Peninsula Podiatry Llc
Bldg 4 2, 30 North 18th Avenue,
Sturgeon Bay, WI 54235-3207
Ph: (920) 743-6668 |
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