Dr Douglas Walsh, MD is a medicare enrolled "Dermatology" physician in Fayetteville, New York. He went to George Washington University School Of Medicine and graduated in 1989 and has 35 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Dr. Fazeli And Dr. Broumand Llc and his current practice location is
4110 Medical Center Drive, Dermatology Associates, Fayetteville, New York. You can reach out to his office (for appointments etc.) via phone at
(706) 267-6239.
Dr Douglas Walsh is licensed to practice in Maryland (license number D0041304) 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 1306860119.
Physician's Profile
| Full Name | Dr Douglas Walsh |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 35 Years |
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| Location | 4110 Medical Center Drive, Fayetteville, New York |
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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 Douglas Walsh attended and graduated from George Washington University School Of Medicine in 1989
NPI Data:
- NPI Number: 1306860119
- Provider Enumeration Date: 07/26/2006
- Last Update Date: 03/03/2016
Medicare PECOS Information:
- PECOS PAC ID: 8628318961
- Enrollment ID: I20190322000809
Medical Identifiers
Medical identifiers for Dr Douglas Walsh such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1306860119 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | D0041304 (Maryland) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Dr. Fazeli And Dr. Broumand Llc | 0446358063 | 9 |
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 Douglas Walsh allows following entities to bill medicare on his behalf.
| Entity Name | Dr. Fazeli & Dr. Broumand Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1336235639
PECOS PAC ID: 0446358063
Enrollment ID: O20070606000029 |
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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 Douglas Walsh 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 |
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Dr Douglas Walsh, MD
6154 Springdale Cir,
Syracuse, NY 13224-2075
Ph: (706) 267-6239 | Dr Douglas Walsh, MD
4110 Medical Center Drive, Dermatology Associates,
Fayetteville, NY 13066-2075
Ph: (706) 267-6239 |
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