Shane Sullivan, in Durham, NC - Medicare Physical Medicine & Rehabilitation

Shane Sullivan, is a medicare enrolled "Physical Medicine & Rehabilitation - Sports Medicine" physician in Durham, North Carolina. His current practice location is 4221 Garrett Rd, Durham, North Carolina. You can reach out to his office (for appointments etc.) via phone at (919) 937-9607.

Shane Sullivan is licensed to practice in North Carolina (license number P21873) 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 1184339699.

Contact Information

	Shane Sullivan,
	4221 Garrett Rd, Durham, NC 27707-3467
	(919) 937-9607
	Not Available

Map and Direction

Physician's Profile

Full Name	Shane Sullivan
Gender	Male
Speciality	Physical Medicine & Rehabilitation - Sports Medicine
Location	4221 Garrett Rd, Durham, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184339699
Provider Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023

Medicare PECOS Information:

PECOS PAC ID: 5294186706
Enrollment ID: I20240109004045

Medical Identifiers

Medical identifiers for Shane Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184339699	NPI	-	NPPES
NA	Other		NA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2081S0010X	Physical Medicine & Rehabilitation - Sports Medicine	P21873 (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. Shane Sullivan allows following entities to bill medicare on his behalf.

Entity Name	Agilitas Usa, Inc
Entity Type	Part B Supplier - Physical/occupational Therapy Group In Private Practice
Entity Identifiers	NPI Number: 1962417444 PECOS PAC ID: 3375454648 Enrollment ID: O20130807000042

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. Shane Sullivan 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
Shane Sullivan, 1611 Chesborough Rd, Winston Salem, NC 27127-7317 Ph: (336) 409-6320	Shane Sullivan, 4221 Garrett Rd, Durham, NC 27707-3467 Ph: (919) 937-9607

Reviews and Comments

Physical Medicine & Rehabilitation Doctors in Durham, NC

Elena Hart, MD Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 3643 N Roxboro St, Durham, NC 27704 Phone: 919-470-4000
Dr. Carolyn Keeler, D.O. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: Dumc 3807, Durham, NC 27710 Phone: 919-684-7821
Raphael S. Orenstein, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 120 William Penn Plz, Durham, NC 27704 Phone: 919-220-5255 Fax: 919-220-6971
Mazen Zein, D.O Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: Duke Medicine Circle Spine Center Clinic 1b/1c, Durham, NC 27710 Phone: 919-660-3006
Dr. Paul Edwind Howell Jr., M.D. Physical Medicine & Rehabilitation Medicare: Medicare Enrolled Practice Location: 508 Fulton St # 117, Durham, NC 27705 Phone: 919-286-0411 Fax: 919-416-5913
Eugenia Fay Zimmerman, M.D. Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 120 William Penn Plz, Durham, NC 27704 Phone: 919-220-5255 Fax: 919-220-6971

Shane Sullivan, - Medicare Physical Medicine & Rehabilitation in Durham, NC