Lyea Dorae Shine, is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Pleasant Hope, Missouri. She graduated from nursing school in 2021 and has 5 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Agcny Physicians Pllc, Chag Anesthesia Pc and her current practice location is
502 Mccurry St, Pleasant Hope, Missouri. You can reach out to her office (for appointments etc.) via phone at
(904) 254-3686.
Lyea Dorae Shine is licensed to practice in New York (license number 811313) 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 1396346870.
Provider's Profile
| Full Name | Lyea Dorae Shine |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 5 Years |
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| Location | 502 Mccurry St, Pleasant Hope, 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:
- Lyea Dorae Shine graduated from nursing school in 2021
NPI Data:
- NPI Number: 1396346870
- Provider Enumeration Date: 11/03/2020
- Last Update Date: 06/01/2021
Medicare PECOS Information:
- PECOS PAC ID: 3577963750
- Enrollment ID: I20210609001582
Medical Identifiers
Medical identifiers for Lyea Dorae Shine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1396346870 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 163W00000X | Registered Nurse | 2014029095 (Missouri) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 811313 (New York) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Agcny Physicians Pllc | 4284804345 | 36 |
| Chag Anesthesia Pc | 2668361973 | 54 |
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. Lyea Dorae Shine allows following entities to bill medicare on her behalf.
| Entity Name | Chag Anesthesia PC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1740279017
PECOS PAC ID: 2668361973
Enrollment ID: O20040315000126 |
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| Entity Name | Agcny Physicians PLLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1033497136
PECOS PAC ID: 4284804345
Enrollment ID: O20110826000658 |
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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. Lyea Dorae Shine 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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Lyea Dorae Shine,
Po Box 68,
Fayetteville, NY 13066-0068
Ph: (904) 254-3686 | Lyea Dorae Shine,
502 Mccurry St,
Pleasant Hope, MO 65725-9231
Ph: (904) 254-3686 |
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