Kenneth Trevor Shealy, OD in Douglas, GA - Medicare Optometry Provider

Kenneth Trevor Shealy, OD is a medicare enrolled "Optometrist" provider in Douglas, Georgia. He went to Southern College Of Optometry and graduated in 2020 and has 4 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Tift Regional Health System Inc, Fitzgerald Family Eyecare, P.c. and his current practice location is 1329 Ocilla Rd, Douglas, Georgia. You can reach out to his office (for appointments etc.) via phone at (912) 393-0005.

Kenneth Trevor Shealy is licensed to practice in Georgia (license number OPT003252) 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 1104436922.

Contact Information

	Kenneth Trevor Shealy, OD
	1329 Ocilla Rd, Douglas, GA 31533-2213
	(912) 393-0005
	(912) 393-0058

Map and Direction

Healthcare Provider's Profile

Full Name	Kenneth Trevor Shealy
Gender	Male
Speciality	Optometry
Experience	4 Years
Location	1329 Ocilla Rd, Douglas, Georgia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kenneth Trevor Shealy attended and graduated from Southern College Of Optometry in 2020

NPI Data:

NPI Number: 1104436922
Provider Enumeration Date: 08/06/2020
Last Update Date: 08/06/2020

Medicare PECOS Information:

PECOS PAC ID: 7618388570
Enrollment ID: I20201124003123

Medical Identifiers

Medical identifiers for Kenneth Trevor Shealy such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104436922	NPI	-	NPPES
OPT003252	Other	GA	OPTOMETRY LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	OPT003252 (Georgia)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Tift Regional Health System Inc	2062745169	298
Fitzgerald Family Eyecare, P.c.	5193762912	2

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. Kenneth Trevor Shealy allows following entities to bill medicare on his behalf.

Provider Name	Fitzgerald Family Eyecare, P.c.
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1114938727 PECOS PAC ID: 5193762912 Enrollment ID: O20050413000816

Provider Name	Tift Regional Health System Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1881203305 PECOS PAC ID: 2062745169 Enrollment ID: O20200217002409

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. Kenneth Trevor Shealy 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
Kenneth Trevor Shealy, OD 1329 Ocilla Rd, Douglas, GA 31533-2213 Ph: (912) 393-0005	Kenneth Trevor Shealy, OD 1329 Ocilla Rd, Douglas, GA 31533-2213 Ph: (912) 393-0005

Reviews and Comments

Optometrist in Douglas, GA

Dr. Mark D Moore, OD Optometrist Medicare: Medicare Enrolled Practice Location: 504 Peterson Ave S, Douglas, GA 31533 Phone: 912-389-1230 Fax: 912-389-1260
Fitzgerald Family Eyecare, P.c. Optometrist Medicare: Medicare Enrolled Practice Location: 1329 Ocilla Rd, Douglas, GA 31533 Phone: 912-393-0005 Fax: 912-393-0058
Larry E. Forth O.d.p.c. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 200 Doctors Drive, Suite 105, Douglas, GA 31533 Phone: 912-384-1840 Fax: 912-384-5976
Murphy Eye Center Optometrist Medicare: Medicare Enrolled Practice Location: 305 Shirley Ave, Douglas, GA 31533 Phone: 912-383-7212 Fax: 912-384-4924
Dr. Kevin Adam Murphy, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 305 Shirley Ave, Douglas, GA 31533 Phone: 912-383-7212 Fax: 912-384-4924
Mihai Mocanu, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1450 Bowens Mill Rd Se, Douglas, GA 31533 Phone: 912-384-0119

Kenneth Trevor Shealy, OD - Medicare Optometrist in Douglas, GA