Cody Shawn Groll, DDS in Pittsburg, KS - Medicare Dentist Provider

Cody Shawn Groll, DDS is a medicare enrolled "Dentist" provider in Pittsburg, Kansas. His current practice location is 3011 N Michigan St, Pittsburg, Kansas. You can reach out to his office (for appointments etc.) via phone at (202) 319-8736.

Cody Shawn Groll is licensed to practice in Kansas (license number 61967) 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 1215662788.

Contact Information

	Cody Shawn Groll, DDS
	3011 N Michigan St, Pittsburg, KS 66762-2546
	(202) 319-8736
	(620) 231-5062

Map and Direction

Healthcare Provider's Profile

Full Name	Cody Shawn Groll
Gender	Male
Speciality	Dentist
Location	3011 N Michigan St, Pittsburg, Kansas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1215662788
Provider Enumeration Date: 07/19/2022
Last Update Date: 02/03/2023

Medicare PECOS Information:

PECOS PAC ID: 0143603571
Enrollment ID: I20220818000829

Medical Identifiers

Medical identifiers for Cody Shawn Groll such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1215662788	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	12891810-9922 (Utah)	Secondary
122300000X	Dentist	61967 (Kansas)	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. Cody Shawn Groll allows following entities to bill medicare on his behalf.

Entity Name	Community Health Center Of Southeast Kansas Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1669474425 PECOS PAC ID: 7911816392 Enrollment ID: O20040209000163

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. Cody Shawn Groll 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
Cody Shawn Groll, DDS Po Box 1808, Pittsburg, KS 66762-1808 Ph: () -	Cody Shawn Groll, DDS 3011 N Michigan St, Pittsburg, KS 66762-2546 Ph: (202) 319-8736

Reviews and Comments

Dentist in Pittsburg, KS

Dr. John Fasbinder, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9873 Fax: 620-231-5062
Robert L Couch, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 3011 N Michigan St, Pittsburg, KS 66762 Phone: 620-231-9873 Fax: 620-231-5062
Timothy P Crawford, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 924 N Broadway St, Pittsburg, KS 66762 Phone: 620-231-6788 Fax: 620-231-2331
Dr. Eric Youvan, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 302 E 4th St, Suite E, Pittsburg, KS 66762 Phone: 620-231-6969 Fax: 620-231-8018
Dr. Albert Mendez, D.D.S Dentist Medicare: Medicare Enrolled Practice Location: 1510 N Broadway St, Pittsburg, KS 66762 Phone: 620-231-6070
David Doshier Russell, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 924 N Broadway St, Pittsburg, KS 66762 Phone: 620-231-6788 Fax: 620-231-2331

Cody Shawn Groll, DDS - Medicare Dentist in Pittsburg, KS