Sanford Medical Specialists Pllc is a medicare enrolled "Internal Medicine - Addiction Medicine" provider in Marne, Michigan. Their current practice location is
15146 16th Ave, Marne, Michigan. You can reach out to their office (for appointments etc.) via phone at
(616) 288-6970.
Sanford Medical Specialists Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Sanford Medical Specialists Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1598437642.
Healthcare Provider's Profile
| Full Name | Sanford Medical Specialists Pllc |
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| Type | Facility |
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| Speciality | Internal Medicine - Addiction Medicine |
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| Location | 15146 16th Ave, Marne, Michigan |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1598437642
- Provider Enumeration Date: 09/28/2021
- Last Update Date: 04/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 1355791575
- Enrollment ID: O20231229000371
Medical Identifiers
Medical identifiers for Sanford Medical Specialists Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1598437642 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 133V00000X | Dietitian, Registered | (* (Not Available)) | Secondary |
| 133VN1201X | Dietitian, Registered - Nutrition, Obesity And Weight Management | (* (Not Available)) | Secondary |
| 207RA0401X | Internal Medicine - Addiction Medicine | (* (Not Available)) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | (* (Not Available)) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Sanford Medical Specialists Pllc acts as a billing entity for following providers:
| Provider Name | Gilbert A Masterson |
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| Provider Type | Practitioner - Psychiatry |
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| Provider Identifiers | NPI Number: 1497740930
PECOS PAC ID: 3375635006
Enrollment ID: I20070824000761 |
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| Provider Name | Kelly J Culmore |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1841760972
PECOS PAC ID: 9537555727
Enrollment ID: I20220418000382 |
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| Provider Name | Nina Johnson Deane |
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| Provider Type | Practitioner - Nurse Practitioner |
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| Provider Identifiers | NPI Number: 1932814787
PECOS PAC ID: 3971940511
Enrollment ID: I20240319002243 |
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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. Sanford Medical Specialists Pllc 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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Sanford Medical Specialists Pllc
15146 16th Ave,
Marne, MI 49435-9605
Ph: () - | Sanford Medical Specialists Pllc
15146 16th Ave,
Marne, MI 49435-9605
Ph: (616) 288-6970 |
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