Shane Benally, OD - Medicare Optometrist in Santo Domingo Pueblo, NM

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Shane Benally, OD is a medicare enrolled "Optometrist" provider in Santo Domingo Pueblo, New Mexico. His current practice location is 85 W Highway 22, Santo Domingo Pueblo, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 465-1169.

Shane Benally is licensed to practice in Idaho (license number ODP-100585) 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 1588387294.

Contact Information

Shane Benally, OD
85 W Highway 22,
Santo Domingo Pueblo, NM 87052-1283
(505) 465-1169
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameShane Benally
GenderMale
SpecialityOptometrist
Location85 W Highway 22, Santo Domingo Pueblo, New Mexico
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1588387294
  • Provider Enumeration Date: 09/19/2022
  • Last Update Date: 07/22/2025
  Medicare PECOS Information:
  • PECOS PAC ID: 7810341260
  • Enrollment ID: I20231004000022

Medical Identifiers

Medical identifiers for Shane Benally such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1588387294NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
152W00000XOptometrist ODP-100585 (Idaho)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 Benally allows following entities to bill medicare on his behalf.
Provider NameDhhs Phs Ihs Phoenix Area
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1265719918
PECOS PAC ID: 2668647108
Enrollment ID: O20111212000142
Provider NameKewa Pueblo Health Corporation
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1467739888
PECOS PAC ID: 7618137779
Enrollment ID: O20120327000617

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 Benally 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 AddressPractice Location Address
Shane Benally, OD
5300 Las Soleras Dr Apt 6003,
Santa Fe, NM 87507-2002

Ph: (901) 653-5701		Shane Benally, OD
85 W Highway 22,
Santo Domingo Pueblo, NM 87052-1283

Ph: (505) 465-1169

Reviews and Comments


Optometrist in Santo Domingo Pueblo, NM


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.