Specialist In Gillette Wyoming

NPI list of 4 specialist registered providers with a business address in Gillette, WY of which 1 are registered as organizations and 3 as individuals. An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

NPI Name Type Taxonomy Address Medicare PECOS
1073701116DUSTIN DARYL MARTINSONIndividualSpecialist1103 E BOXELDER RD STE U
GILLETTE, WY 82718
(307) 686-8177
Non-Participating ProviderNO
1285679670ATTILA T BARABASIndividualSpecialist1405 W 4TH ST
GILLETTE, WY 82716
(307) 688-2665
Accepts MedicareYES
1942664107SUMMIT OBGYN PCOrganizationSpecialist1414 W 4TH ST
GILLETTE, WY 82716
(307) 299-4496
Non-Participating ProviderNO
1235600891AUDRA STUMBAUGHIndividualSpecialist10 ARCTIC AVE
GILLETTE, WY 82718
(307) 670-2181
Non-Participating ProviderNO

Medicare Participation

  • Participating providers are registered with Medicare and accept claims assignment. Taking claims assignment means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or co-payment amount for a visit or service.
  • Non-Participating providers do not agree to take Medicare claims assignment. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
  • Opt-out providers signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so.

What is PECOS?

PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals eligible to order or refer healthcare services for Medicare patients.