Mr Robert Lee Ridgeway Iv, PA-C is a medicare enrolled "Dermatology" in Anderson, South Carolina. He graduated from nursing school in 2014 and has 12 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Anderson Skin And Cancer Clinic Pa and his current practice location is
2022 Cardinal Cir, Anderson, South Carolina. You can reach out to his office (for appointments etc.) via phone at
(864) 224-7577.
Mr Robert Lee Ridgeway Iv is licensed to practice in South Carolina (license number 2119) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1942616750.
Provider's Profile
| Full Name | Mr Robert Lee Ridgeway Iv |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 12 Years |
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| Location | 2022 Cardinal Cir, Anderson, South Carolina |
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| Accepts Medicare Assignments | Yes. He 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:
- Mr Robert Lee Ridgeway Iv graduated from nursing school in 2014
NPI Data:
- NPI Number: 1942616750
- Provider Enumeration Date: 07/02/2014
- Last Update Date: 12/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 5294955431
- Enrollment ID: I20181022002707
Medical Identifiers
Medical identifiers for Mr Robert Lee Ridgeway Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1942616750 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 2119 (South Carolina) | Secondary |
| 363AS0400X | Physician Assistant - Surgical | 2119 (South Carolina) | Secondary |
| 207N00000X | Dermatology | 2119 (South Carolina) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Anderson Skin And Cancer Clinic Pa | 1254313232 | 8 |
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. Mr Robert Lee Ridgeway Iv allows following entities to bill medicare on his behalf.
| Entity Name | Anderson Skin and Cancer Clinic PA |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1639398480
PECOS PAC ID: 1254313232
Enrollment ID: O20040603000508 |
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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. Mr Robert Lee Ridgeway Iv 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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Mr Robert Lee Ridgeway Iv, PA-C
2022 Cardinal Cir,
Anderson, SC 29621-1504
Ph: (864) 224-7577 | Mr Robert Lee Ridgeway Iv, PA-C
2022 Cardinal Cir,
Anderson, SC 29621-1504
Ph: (864) 224-7577 |
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