Dr Edward Tracy Sall, MD,DDS is a medicare enrolled "Otolaryngology - Otolaryngic Allergy" provider in Fayetteville, New York. He went to State University Of Ny Upstate Medical University and graduated in 1987 and has 38 years of diverse experience with area of expertise as Otolaryngology. He is a member of the group practice Sd Diagnostics Inc, Advanced Ent Physicians And Surgeons Of Cny Pc, Sd Diagnostics Inc and his current practice location is
4000 Medical Center Dr., Ste 404, Fayetteville, New York. You can reach out to his office (for appointments etc.) via phone at
(315) 234-9865.
Dr Edward Tracy Sall is licensed to practice in New York (license number 181365) 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 1710961198.
Healthcare Provider's Profile
Full Name | Dr Edward Tracy Sall |
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Gender | Male |
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Speciality | Otolaryngology |
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Experience | 38 Years |
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Location | 4000 Medical Center Dr., Fayetteville, New York |
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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. |
Medical Education and Training:
- Dr Edward Tracy Sall attended and graduated from State University Of Ny Upstate Medical University in 1987
NPI Data:
- NPI Number: 1710961198
- Provider Enumeration Date: 11/30/2005
- Last Update Date: 06/18/2024
Medicare PECOS Information:
- PECOS PAC ID: 7214984467
- Enrollment ID: I20090522000375
Medical Identifiers
Medical identifiers for Dr Edward Tracy Sall such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710961198 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 104553 (California) | Secondary |
207YX0602X | Otolaryngology - Otolaryngic Allergy | 181365 (New York) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Sd Diagnostics Inc | 3870723950 | 8 |
Advanced Ent Physicians And Surgeons Of Cny Pc | 9436233848 | 2 |
Sd Diagnostics Inc | 3870723950 | 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. Dr Edward Tracy Sall allows following entities to bill medicare on his behalf.
Entity Name | Advanced Ent Physicians & Surgeons Of Cny Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1891827663 PECOS PAC ID: 9436233848 Enrollment ID: O20080225000236 |
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Entity Name | Sd Diagnostics Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1487192779 PECOS PAC ID: 3870723950 Enrollment ID: O20230705000754 |
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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. Dr Edward Tracy Sall 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 |
Dr Edward Tracy Sall, MD,DDS 5471 Kearny Villa Rd Ste 200, San Diego, CA 92123-1143 Ph: (866) 801-9440 | Dr Edward Tracy Sall, MD,DDS 4000 Medical Center Dr., Ste 404, Fayetteville, NY 13066 Ph: (315) 234-9865 |
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