Charles E Moisan Jr, MD is a medicare enrolled "Internal Medicine" physician in Elizabethtown, New York. His current practice location is
74 Park St, Elizabethtown, New York. You can reach out to his office (for appointments etc.) via phone at
(518) 873-6340.
Charles E Moisan Jr is licensed to practice in New York (license number 102273) 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 1538114855.
Physician's Profile
| Full Name | Charles E Moisan Jr |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 74 Park St, Elizabethtown, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1538114855
- Provider Enumeration Date: 05/24/2006
- Last Update Date: 09/14/2018
Medicare PECOS Information:
- PECOS PAC ID: 4183753148
- Enrollment ID: I20100608000428
Medical Identifiers
Medical identifiers for Charles E Moisan Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538114855 | NPI | - | NPPES |
| 00636686 | Medicaid | NY | |
| 111002291 | Other | NY | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 102273 (New York) | 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. Charles E Moisan Jr allows following entities to bill medicare on his behalf.
| Entity Name | Essex County Treasurer |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659485480
PECOS PAC ID: 1658392600
Enrollment ID: O20051219000132 |
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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. Charles E Moisan Jr 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 |
|---|
Charles E Moisan Jr, MD
74 Park St,
Elizabethtown, NY 12932-2303
Ph: (518) 873-6340 | Charles E Moisan Jr, MD
74 Park St,
Elizabethtown, NY 12932-2303
Ph: (518) 873-6340 |
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