Dr James M Pribula, MD - Medicare Pediatrics in Sharon, CT

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Dr James M Pribula, MD is a medicare enrolled "Pediatrics" physician in Sharon, Connecticut. His current practice location is 29 Hospital Hill Rd, Suite 1600, Sharon, Connecticut. You can reach out to his office (for appointments etc.) via phone at (860) 364-5585.

Dr James M Pribula is licensed to practice in Massachusetts (license number 78208) 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 1255331526.

Contact Information

Dr James M Pribula, MD
29 Hospital Hill Rd, Suite 1600,
Sharon, CT 06069-2095
(860) 364-5585
Not Available

Map and Direction




Physician's Profile

Full NameDr James M Pribula
GenderMale
SpecialityPediatrics
Location29 Hospital Hill Rd, Sharon, Connecticut
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1255331526
  • Provider Enumeration Date: 07/28/2005
  • Last Update Date: 01/16/2014
  Medicare PECOS Information:
  • PECOS PAC ID: 7719928068
  • Enrollment ID: I20050517000344

Medical Identifiers

Medical identifiers for Dr James M Pribula such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1255331526NPI-NPPES
043202198OtherHEALTH CARE VALUE MGMT
15567OtherHEALTH NEW ENGLAND
J30037OtherBC/BS OF MASSACHUSETTS
0030464OtherNEIGHBORHOOD HEALTH PLAN
043202198-015OtherCIGNA
J30037OtherHMO BLUE
043202198OtherFIRST HEALTH
78208OtherCONNECTICARE OF MA
000000008393OtherBOSTON MEDICAL CENTER HNP
043202198OtherCHILDRENS MED PLAN
043202198OtherGREAT WEST HEALTH PLAN
043202198OtherCBA
043202198OtherHMC - PPO
3112942MedicaidMA
043202198OtherBEECH STREET
043202198OtherCONSOLIDATED HEALTH PLAN
043202198OtherMULTI-PLAN
18252OtherHARVARD PILGRIM

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 78208 (Massachusetts)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 James M Pribula allows following entities to bill medicare on his behalf.
Entity NameCd Practice Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295787919
PECOS PAC ID: 2567359839
Enrollment ID: O20040302000290
Entity NamePhysicians Of Falmouth Hospital
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1821363698
PECOS PAC ID: 6800051970
Enrollment ID: O20120625000127

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 James M Pribula 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 AddressPractice Location Address
Dr James M Pribula, MD
Po Box 789,
Sharon, CT 06069-0789

Ph: (860) 364-4471		Dr James M Pribula, MD
29 Hospital Hill Rd, Suite 1600,
Sharon, CT 06069-2095

Ph: (860) 364-5585

Reviews and Comments


Pediatrics Doctors in Sharon, CT

Dr. Malcolm Michael Brown, M.D.
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 62 Upper Main Street, Box 584, Sharon, CT 06069
Phone: 860-364-5864    Fax: 860-364-5864
Amy M. Tocco, M.D.
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 50 Hospital Hill Rd, Sharon, CT 06069
Phone: 860-364-4515    
Catherine Devlin Leidigh, MD
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 29 Hospital Hill Rd, Suite #1400, Sharon, CT 06069
Phone: 860-364-5523    Fax: 860-364-0544
Virginia L Gray-clarke, M.D
Pediatrics
Medicare: Not Enrolled in Medicare
Practice Location: 29 Hospital Hill Rd, Suite 1600, Sharon, CT 06069
Phone: 860-364-5585    Fax: 860-364-5078

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.