Mr Thomas J Africano, CRNA is a medicare enrolled "Anesthesiology" physician in Flossmoor, Illinois. His current practice location is
19624 Governors Hwy, Flossmoor, Illinois. You can reach out to his office (for appointments etc.) via phone at
(708) 798-5838.
Mr Thomas J Africano is licensed to practice in Illinois (license number 209003144) 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 1750393328.
Physician's Profile
| Full Name | Mr Thomas J Africano |
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| Gender | Male |
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| Speciality | Anesthesiology |
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| Location | 19624 Governors Hwy, Flossmoor, Illinois |
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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: 1750393328
- Provider Enumeration Date: 08/12/2006
- Last Update Date: 01/09/2008
Medicare PECOS Information:
- PECOS PAC ID: 5294823860
- Enrollment ID: I20071115000077
Medical Identifiers
Medical identifiers for Mr Thomas J Africano such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750393328 | NPI | - | NPPES |
| 430004550 | Other | IL | PALMETTO GBA/ RR MEDICARE |
| 363175240 | Other | IL | TAX I.D. |
| 1617253 | Other | IL | BCBS PROVIDER ID |
| 0004241899 | Other | IL | AETNA PIN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207L00000X | Anesthesiology | 209003144 (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. Mr Thomas J Africano allows following entities to bill medicare on his behalf.
| Entity Name | Lake Anesthesia Associates |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528260635
PECOS PAC ID: 9830287416
Enrollment ID: O20071115000086 |
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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. Mr Thomas J Africano 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 |
|---|
Mr Thomas J Africano, CRNA
Po Box 158,
Flossmoor, IL 60422-0158
Ph: (708) 798-5838 | Mr Thomas J Africano, CRNA
19624 Governors Hwy,
Flossmoor, IL 60422-2077
Ph: (708) 798-5838 |
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