Dr Shane Jensen, OD is a medicare enrolled "Optometrist" provider in Panguitch, Utah. He went to Pacific University - College Of Optometry and graduated in 2003 and has 21 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Eastern Utah Eye Physicians and his current practice location is
415 E. Center Street, Panguitch, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 676-8646.
Dr Shane Jensen is licensed to practice in Utah (license number 5354482-9934) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1154422822.
Healthcare Provider's Profile
| Full Name | Dr Shane Jensen |
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| Gender | Male |
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| Speciality | Optometry |
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| Experience | 21 Years |
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| Location | 415 E. Center Street, Panguitch, Utah |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Shane Jensen attended and graduated from Pacific University - College Of Optometry in 2003
NPI Data:
- NPI Number: 1154422822
- Provider Enumeration Date: 09/26/2006
- Last Update Date: 06/16/2008
Medicare PECOS Information:
- PECOS PAC ID: 6204737737
- Enrollment ID: I20040117000211
Medical Identifiers
Medical identifiers for Dr Shane Jensen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154422822 | NPI | - | NPPES |
| 53544829900001 | Other | UT | BLUECROSS BLUESHIELD |
| 043753766 | Other | UT | TRICARE |
| D5075 | Medicaid | UT | |
| 043753766 | Other | UT | HUMANA |
| 5354482-9934 | Other | UT | PEHP |
| 107028627101 | Other | UT | IHC |
| RR27009 | Other | UT | SPECTERA |
| 270343 | Other | UT | ALTIUS |
| 1595696 | Other | UT | OPTICHOICE |
| 813540 | Other | UT | DMBA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 152W00000X | Optometrist | 5354482-9934 (Utah) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Eastern Utah Eye Physicians | 6204869233 | 4 |
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 Shane Jensen allows following entities to bill medicare on his behalf.
| Provider Name | Eastern Utah Eye Physicians |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1881801504
PECOS PAC ID: 6204869233
Enrollment ID: O20050912000346 |
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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 Shane Jensen 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 Shane Jensen, OD
P.o. Box 592,
Panguitch, UT 84759
Ph: (435) 676-2761 | Dr Shane Jensen, OD
415 E. Center Street,
Panguitch, UT 84759
Ph: (435) 676-8646 |
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