P Michael Shattuck, MD in Berlin, WI - Medicare Emergency Medicine

P Michael Shattuck, MD is a medicare enrolled "Emergency Medicine" physician in Berlin, Wisconsin. His current practice location is 225 Memorial Dr, Berlin, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (920) 361-5538.

P Michael Shattuck is licensed to practice in Wisconsin (license number 25430) 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 1740273630.

Contact Information

	P Michael Shattuck, MD
	225 Memorial Dr, Berlin, WI 54923-1243
	(920) 361-5538
	(920) 361-5499

Map and Direction

Physician's Profile

Full Name	P Michael Shattuck
Gender	Male
Speciality	Emergency Medicine
Location	225 Memorial Dr, Berlin, Wisconsin
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1740273630
Provider Enumeration Date: 08/25/2005
Last Update Date: 07/26/2023

Medicare PECOS Information:

PECOS PAC ID: 9638167141
Enrollment ID: I20040504000545

Medical Identifiers

Medical identifiers for P Michael Shattuck such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1740273630	NPI	-	NPPES
30668600	Medicaid	WI

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	25430-020 (Wisconsin)	Secondary
208600000X	Surgery	25430-020 (Wisconsin)	Secondary
207P00000X	Emergency Medicine	25430 (Wisconsin)	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. P Michael Shattuck allows following entities to bill medicare on his behalf.

Entity Name	Thedacare Incorporated
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376656959 PECOS PAC ID: 1759294887 Enrollment ID: O20031106000088

Entity Name	Thedacare Medical Center - Berlin Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1760413777 PECOS PAC ID: 0446151666 Enrollment ID: O20040120000214

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. P Michael Shattuck 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
P Michael Shattuck, MD 225 Memorial Dr, Berlin, WI 54923-1243 Ph: (920) 361-1313	P Michael Shattuck, MD 225 Memorial Dr, Berlin, WI 54923-1243 Ph: (920) 361-5538

Reviews and Comments

Emergency Medicine Doctors in Berlin, WI

Mary Swieskowski Cummins, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 225 Memorial Dr, Berlin, WI 54923 Phone: 920-361-1313
Erin K Eferem, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 225 Memorial Dr, Berlin, WI 54923 Phone: 920-361-5525
Daniel Perrault, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 225 Memorial Dr, Berlin, WI 54923 Phone: 920-361-5525 Fax: 920-361-5925
Kenneth Sullivan, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 225 Memorial Dr, Berlin, WI 54923 Phone: 920-361-5525

P Michael Shattuck, MD - Medicare Emergency Medicine in Berlin, WI