Medicare Doctor Lists – How to Find a Medicare Doctor

As most Americans are aware, Medicare is the health insurance program administered by the U.S. Government. Most people are automatically eligible for Medicare coverage on their 65th birthday.  Some persons younger than 65 can be covered by Medicare insurance by meeting certain disability requirements. 

The first step is to become eligible for Medicare.  The next step in taking advantage of this national health insurance program is to find a Medicare doctor.

The website Medicare.gov contains a searchable database to help you find a participating Medicare doctor in your area with the specialty you require.  But locating a Medicare doctor is not as simple as clicking the search button!

The database contains basic information for each Medicare doctor such as name, address, phone, and area of practice or medical specialty.  Each Medicare doctor in the database has agreed to accept Medicare payments for services rendered. 

Potential patients are encouraged to verify addresses and phone numbers prior to visiting the office, as these are subject to change.  Furthermore, a Medicare doctor who joins the database in mid-year may not immediately appear in the list.

Detailed Medicare doctor information is presented as well.  These details can include medical school attended and date graduated, specialties, certifications, the doctor’s gender, which hospitals the doctor is affiliated with, and even any foreign language(s) spoken by the doctor.  These details allow potential patients to select a Medicare doctor with the age, gender, and specialty that makes the patient comfortable.

One frustrating feature of the database is that it does not indicate whether each Medicare doctor is accepting new Medicare patients.  If you find a convenient Medicare doctor in your area, call his office to confirm that new Medicare patients are welcome.  If not, you may be stuck paying the bill yourself.

The database can be confusing because a Medicare doctor listed as accepting Medicare assignments may be listed in a medical group or clinic that does not!  This means that a patient seeing a Medicare doctor in a non-Medicare clinic will likely pay more than if they had been treated in the doctor’s private office where Medicare is accepted. Potential patients need to verify with the Medicare doctor as to which office is covered by Medicare insurance.

The Medicare doctor database is not a complete listing of all physicians.  Only those accepting Medicare are included.  It also does not include a Medicare doctor who has been excluded from receiving Medicare payments, even if he or she received them in the past.  Doctors who have opted-out of the Medicare program are not included, or will be removed if they were former Medicare providers.

Medicare information is subject to change without notice.  Please check for updated information before relying entirely on the information presented here.  It can save you both money and aggravation.

2 Responses to Medicare Doctor Lists – How to Find a Medicare Doctor

  • beth greenstein says:

    Please advise how I can find out if my Medicare Provider number is active. The Medicare ID-unspecified is K6959 and Z6959, Medicare UPIN is P62914.
    My former name was Beth Fowler
    Thank you

  • richard f says:

    my dr put me on full disability in 2006 i was 43 at that time. now i am 47 still on full disabilty, my health has gotten worse. most of my life i held good jobs, so my ssdi payment is around 1500 a month. this is below poverty levels to have an apartment pay utilities have a phone. why can’t i get medicaid or food stamps? i may not pass away for a long time, but i am severally depressed, no 401 k plan i had to spend it to try and survive on my own. now i share an apartment with my sister, but her job don’t pay well, we are barely getiing by, any suggestions? desperate in Toledo Ohio

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