Dr Connor William Haysbert, MD is a medicare enrolled "Pediatrics" physician in Scotts Valley, California. His current practice location is
5615 Scotts Valley Dr, Scotts Valley, California. You can reach out to his office (for appointments etc.) via phone at
(831) 430-2700.
Dr Connor William Haysbert is licensed to practice in California (license number A183499) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1013415116.
Physician's Profile
Full Name | Dr Connor William Haysbert |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 5615 Scotts Valley Dr, Scotts Valley, California |
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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: 1013415116
- Provider Enumeration Date: 01/24/2018
- Last Update Date: 11/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 3779956297
- Enrollment ID: I20230303001722
Medical Identifiers
Medical identifiers for Dr Connor William Haysbert such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013415116 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | A183499 (California) | 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. Dr Connor William Haysbert allows following entities to bill medicare on his behalf.
Entity Name | Permanente Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
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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. Dr Connor William Haysbert 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 |
Dr Connor William Haysbert, MD 4998 Perceptive Way, Sacramento, CA 95842-3634 Ph: (916) 834-5912 | Dr Connor William Haysbert, MD 5615 Scotts Valley Dr, Scotts Valley, CA 95066-3492 Ph: (831) 430-2700 |
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