Dr Charli Walter Leroy Smith Jr, MD in Harrisburg, IL

Dr Charli Walter Leroy Smith Jr, MD is a medicare enrolled "Family Medicine" physician in Harrisburg, Illinois. His current practice location is 608 Rollie Moore Dr, Harrisburg, Illinois. You can reach out to his office (for appointments etc.) via phone at (618) 252-6150.

Dr Charli Walter Leroy Smith Jr is licensed to practice in Illinois (license number 036139019) 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 1649611252.

Contact Information

	Dr Charli Walter Leroy Smith Jr, MD
	608 Rollie Moore Dr, Harrisburg, IL 62946-2351
	(618) 252-6150
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Charli Walter Leroy Smith Jr
Gender	Male
Speciality	Family Medicine
Location	608 Rollie Moore Dr, Harrisburg, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1649611252
Provider Enumeration Date: 07/11/2013
Last Update Date: 05/13/2022

Medicare PECOS Information:

PECOS PAC ID: 4880836204
Enrollment ID: I20160628000691

Medical Identifiers

Medical identifiers for Dr Charli Walter Leroy Smith Jr such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1649611252	NPI	-	NPPES
214881	Other	IL	MEDICARE GROUP

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2083P0011X	Preventive Medicine - Undersea And Hyperbaric Medicine	036139019 (Illinois)	Secondary
207Q00000X	Family Medicine	036139019 (Illinois)	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 Charli Walter Leroy Smith Jr allows following entities to bill medicare on his behalf.

Entity Name	Illinois Department Of Human Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1003960394 PECOS PAC ID: 9830003920 Enrollment ID: O20031113000414

Entity Name	Southern Illinois Medical Services Nfp
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1770656837 PECOS PAC ID: 3678677390 Enrollment ID: O20070404000595

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 Charli Walter Leroy Smith Jr 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 Charli Walter Leroy Smith Jr, MD 7209 Moake School Rd, Marion, IL 62959-7782 Ph: (262) 488-2395	Dr Charli Walter Leroy Smith Jr, MD 608 Rollie Moore Dr, Harrisburg, IL 62946-2351 Ph: (618) 252-6150

Reviews and Comments

Family Medicine Doctors in Harrisburg, IL

Brent M Jones, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-351-4859
Dr. Matthew C Winkleman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2540
Timothy E Morthland, M.D. Family Medicine Medicare: Medicare Enrolled Practice Location: 100 Dr Warren Tuttle Dr, Harrisburg, IL 62946 Phone: 618-253-7671
Dr. Roger D Watters, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2540
Mr. Steven D Knight, Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2540
Dr. Laura M Winkleman, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-351-4859
Mr. Larry R Jones, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 117 E Clark St, Harrisburg, IL 62946 Phone: 618-252-8625 Fax: 618-252-2540

Dr Charli Walter Leroy Smith Jr, MD - Medicare Family Medicine in Harrisburg, IL