Dr Edward Tracy Sall, MD,DDS is a medicare enrolled "Otolaryngology - Otolaryngic Allergy" provider in Fayetteville, New York. He went to State University Of Ny Upstate Medical University and graduated in 1992 and has 34 years of diverse experience with area of expertise as Sleep Medicine. He is a member of the group practice Sd Diagnostics Inc, Goto Sleep, Advanced Ent Physicians And Surgeons Of Cny Pc and his current practice location is
4000 Medical Center Dr., Ste 404, Fayetteville, New York. You can reach out to his office (for appointments etc.) via phone at
(315) 234-9865.
Dr Edward Tracy Sall is licensed to practice in New York (license number 181365) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1710961198.
Healthcare Provider's Profile
| Full Name | Dr Edward Tracy Sall |
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| Gender | Male |
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| Speciality | Sleep Medicine |
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| Experience | 34 Years |
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| Location | 4000 Medical Center Dr., Fayetteville, New York |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Edward Tracy Sall attended and graduated from State University Of Ny Upstate Medical University in 1992
NPI Data:
- NPI Number: 1710961198
- Provider Enumeration Date: 11/30/2005
- Last Update Date: 06/18/2024
Medicare PECOS Information:
- PECOS PAC ID: 7214984467
- Enrollment ID: I20210222000494
Medical Identifiers
Medical identifiers for Dr Edward Tracy Sall such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1710961198 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 104553 (California) | Secondary |
| 207YX0602X | Otolaryngology - Otolaryngic Allergy | 181365 (New York) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
| Sd Diagnostics Inc | 3870723950 | 7 |
| Goto Sleep | 8527324615 | 7 |
| Advanced Ent Physicians And Surgeons Of Cny Pc | 9436233848 | 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. Dr Edward Tracy Sall allows following entities to bill medicare on his behalf.
| Entity Name | Sd Diagnostics Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1003252834 PECOS PAC ID: 3870723950 Enrollment ID: O20140312001772 |
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| Entity Name | Edward Sall Dental Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053859710 PECOS PAC ID: 9537464771 Enrollment ID: O20180106000054 |
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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 Edward Tracy Sall 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 Edward Tracy Sall, MD,DDS 5471 Kearny Villa Rd Ste 200, San Diego, CA 92123-1143 Ph: (866) 801-9440 | Dr Edward Tracy Sall, MD,DDS 4000 Medical Center Dr., Ste 404, Fayetteville, NY 13066 Ph: (315) 234-9865 |
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