Kenneth Adam Gerasimovich, is a medicare enrolled "Student In An Organized Health Care Education/training Program" in Glen Head, New York. His current practice location is
11 Willow Pl, Glen Head, New York. You can reach out to his office (for appointments etc.) via phone at
(516) 528-0194.
Kenneth Adam Gerasimovich is licensed to practice in * (Not Available) (license number ) 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 1013654854.
Provider's Profile
Full Name | Kenneth Adam Gerasimovich |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 11 Willow Pl, Glen Head, New York |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1013654854
- Provider Enumeration Date: 05/13/2022
- Last Update Date: 01/10/2023
Medicare PECOS Information:
- PECOS PAC ID: 2567827637
- Enrollment ID: I20230424002596
Medical Identifiers
Medical identifiers for Kenneth Adam Gerasimovich such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1013654854 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Kenneth Adam Gerasimovich 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 |
Kenneth Adam Gerasimovich, 11 Willow Pl, Glen Head, NY 11545-1561 Ph: (516) 528-0194 | Kenneth Adam Gerasimovich, 11 Willow Pl, Glen Head, NY 11545-1561 Ph: (516) 528-0194 |
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