Dr Kerry Mark Shafran, MD is a medicare enrolled "Dermatology" physician in Cornelius, North Carolina. His current practice location is
17039 Kenton Dr Ste 100, Cornelius, North Carolina. You can reach out to his office (for appointments etc.) via phone at
(704) 896-8837.
Dr Kerry Mark Shafran is licensed to practice in North Carolina (license number 39997) 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 1740394543.
Physician's Profile
| Full Name | Dr Kerry Mark Shafran |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 17039 Kenton Dr Ste 100, Cornelius, North Carolina |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1740394543
- Provider Enumeration Date: 08/18/2006
- Last Update Date: 10/20/2021
Medicare PECOS Information:
- PECOS PAC ID: 5395736987
- Enrollment ID: I20120308000561
Medical Identifiers
Medical identifiers for Dr Kerry Mark Shafran such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1740394543 | NPI | - | NPPES |
| 0179T | Other | NC | BLUE CROSS BLUE SHIELD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | 39997 (North Carolina) | 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 Kerry Mark Shafran allows following entities to bill medicare on his behalf.
| Entity Name | Skin Surgery Center Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1649237082
PECOS PAC ID: 3173599479
Enrollment ID: O20040908000943 |
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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 Kerry Mark Shafran 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 Kerry Mark Shafran, MD
17039 Kenton Dr Ste 100,
Cornelius, NC 28031-5776
Ph: (704) 896-8837 | Dr Kerry Mark Shafran, MD
17039 Kenton Dr Ste 100,
Cornelius, NC 28031-5776
Ph: (704) 896-8837 |
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