Shana Widick Rose, MD is a medicare enrolled "Ophthalmology" physician in Fenton, Missouri. She graduated from medical school in 2011 and has 13 years of diverse experience with area of expertise as Ophthalmology. She is a member of the group practice Envision Eye Specialists Pc and her current practice location is
1011 Bowles Ave, Suite 415, Fenton, Missouri. You can reach out to her office (for appointments etc.) via phone at
(636) 717-1700.
Shana Widick Rose is licensed to practice in Missouri (license number 2011014018) 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 1508020645.
Physician's Profile
| Full Name | Shana Widick Rose |
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| Gender | Female |
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| Speciality | Ophthalmology |
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| Experience | 13 Years |
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| Location | 1011 Bowles Ave, Fenton, Missouri |
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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:
- Shana Widick Rose graduated from medical school in 2011
NPI Data:
- NPI Number: 1508020645
- Provider Enumeration Date: 07/17/2008
- Last Update Date: 01/23/2015
Medicare PECOS Information:
- PECOS PAC ID: 5395914162
- Enrollment ID: I20110811000648
Medical Identifiers
Medical identifiers for Shana Widick Rose such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1508020645 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207W00000X | Ophthalmology | 2011014018 (Missouri) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Envision Eye Specialists Pc | 0042375941 | 5 |
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. Shana Widick Rose allows following entities to bill medicare on her behalf.
| Entity Name | Retina Center Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1861539694
PECOS PAC ID: 5890758296
Enrollment ID: O20041108000008 |
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| Entity Name | Envision Eye Specialists Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205072360
PECOS PAC ID: 0042375941
Enrollment ID: O20090210000052 |
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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. Shana Widick Rose 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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Shana Widick Rose, MD
1011 Bowles Ave, Suite 200,
Fenton, MO 63026-2395
Ph: (636) 717-1700 | Shana Widick Rose, MD
1011 Bowles Ave, Suite 415,
Fenton, MO 63026-2395
Ph: (636) 717-1700 |
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