Sally A Burtle, MD is a medicare enrolled "Dermatology" physician in Richmond, California. She went to Hahnemann University College Of Medicine and graduated in 2000 and has 25 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Greenbrae Dermatology, A Medical Corporation and her current practice location is
901 Nevin Ave, Richmond, California. You can reach out to her office (for appointments etc.) via phone at
(510) 307-2372.
Sally A Burtle is licensed to practice in California (license number A94836) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1821093972.
Physician's Profile
| Full Name | Sally A Burtle |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 25 Years |
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| Location | 901 Nevin Ave, Richmond, California |
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| Accepts Medicare Assignments | Yes. She 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:
- Sally A Burtle attended and graduated from Hahnemann University College Of Medicine in 2000
NPI Data:
- NPI Number: 1821093972
- Provider Enumeration Date: 06/16/2005
- Last Update Date: 12/13/2021
Medicare PECOS Information:
- PECOS PAC ID: 7719957505
- Enrollment ID: I20070501000351
Medical Identifiers
Medical identifiers for Sally A Burtle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1821093972 | NPI | - | NPPES |
| 3648861 | Other | PA | AETNA |
| 2224495000 | Other | PA | KEYSTONE HP EAST |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | MD422621 (Pennsylvania) | Secondary |
| 207N00000X | Dermatology | A94836 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Greenbrae Dermatology, A Medical Corporation | 4789832908 | 7 |
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. Sally A Burtle allows following entities to bill medicare on her behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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| Entity Name | Greenbrae Dermatology, A Medical Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174898654
PECOS PAC ID: 4789832908
Enrollment ID: O20130123000375 |
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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. Sally A Burtle 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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Sally A Burtle, MD
901 Nevin Ave,
Richmond, CA 94801-3143
Ph: (510) 307-2372 | Sally A Burtle, MD
901 Nevin Ave,
Richmond, CA 94801-3143
Ph: (510) 307-2372 |
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