Blaine Aaron Concannon, is a medicare enrolled "Emergency Medicine" physician in Concord Township, Ohio. His current practice location is
7590 Auburn Rd, Concord Township, Ohio. You can reach out to his office (for appointments etc.) via phone at
(440) 375-8100.
Blaine Aaron Concannon is licensed to practice in Ohio (license number 35.149837) 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 1063099273.
Physician's Profile
Full Name | Blaine Aaron Concannon |
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Gender | Male |
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Speciality | Emergency Medicine |
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Location | 7590 Auburn Rd, Concord Township, Ohio |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1063099273
- Provider Enumeration Date: 03/24/2021
- Last Update Date: 07/22/2024
Medicare PECOS Information:
- PECOS PAC ID: 7719388958
- Enrollment ID: I20240402001990
Medical Identifiers
Medical identifiers for Blaine Aaron Concannon such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1063099273 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | 35.149837 (Ohio) | 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. Blaine Aaron Concannon allows following entities to bill medicare on his behalf.
Entity Name | Emergency Medicine Physicians Of Lake County Ltd |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1154763944 PECOS PAC ID: 0042444051 Enrollment ID: O20131007000784 |
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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. Blaine Aaron Concannon 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 |
Blaine Aaron Concannon, 7590 Auburn Rd, Concord Township, OH 44077-9176 Ph: (440) 375-8100 | Blaine Aaron Concannon, 7590 Auburn Rd, Concord Township, OH 44077-9176 Ph: (440) 375-8100 |
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