Hind Mirza Gautam, MD - Medicare Interventional Pain Management in De Pere, WI

Hind Mirza Gautam, MD is a medicare enrolled "Pain Medicine - Interventional Pain Medicine" physician in De Pere, Wisconsin. She graduated from medical school in 1997 and has 27 years of diverse experience with area of expertise as Interventional Pain Management. She is a member of the group practice Aurora Medical Group, Inc. and her current practice location is 1881 Chicago St, De Pere, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (920) 403-8000.

Hind Mirza Gautam is licensed to practice in Wisconsin (license number 49944) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1316950504.

Contact Information

Hind Mirza Gautam, MD
1881 Chicago St,
De Pere, WI 54115-3770
(920) 403-8000
Not Available



Physician's Profile

Full NameHind Mirza Gautam
GenderFemale
SpecialityInterventional Pain Management
Experience27 Years
Location1881 Chicago St, De Pere, Wisconsin
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Hind Mirza Gautam graduated from medical school in 1997
  NPI Data:
  • NPI Number: 1316950504
  • Provider Enumeration Date: 08/15/2006
  • Last Update Date: 01/08/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 5991807075
  • Enrollment ID: I20070220000299

Medical Identifiers

Medical identifiers for Hind Mirza Gautam such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1316950504NPI-NPPES
34748200MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208VP0014XPain Medicine - Interventional Pain Medicine 49944 (Wisconsin)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Aurora Baycare Medical CtrGreen bay, WIHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Aurora Medical Group, Inc.67097942583207

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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. Hind Mirza Gautam allows following entities to bill medicare on her behalf.
Entity NameAurora Medical Group, Inc.
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1427271378
PECOS PAC ID: 6709794258
Enrollment ID: O20031105000725

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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. Hind Mirza Gautam 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 AddressPractice Location Address
Hind Mirza Gautam, MD
Po Box 735044,
Chicago, IL 60673-5044

Ph: (800) 326-2250
Hind Mirza Gautam, MD
1881 Chicago St,
De Pere, WI 54115-3770

Ph: (920) 403-8000

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Pain Medicine Doctors in De Pere, WI


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