Dominic Jeffrey Haertling, MD is a medicare enrolled "Internal Medicine" physician in Perryville, Missouri. His current practice location is
212 Hospital Ln Ste 202, Perryville, Missouri. You can reach out to his office (for appointments etc.) via phone at
(573) 768-3449.
Dominic Jeffrey Haertling is licensed to practice in Missouri (license number 2023016854) 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 1558821413.
Physician's Profile
| Full Name | Dominic Jeffrey Haertling |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Location | 212 Hospital Ln Ste 202, Perryville, Missouri |
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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: 1558821413
- Provider Enumeration Date: 03/25/2019
- Last Update Date: 09/15/2023
Medicare PECOS Information:
- PECOS PAC ID: 3971837931
- Enrollment ID: I20230810003995
Medical Identifiers
Medical identifiers for Dominic Jeffrey Haertling such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1558821413 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | 2023016854 (Missouri) | Secondary |
| 207R00000X | Internal Medicine | 2023016854 (Missouri) | 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. Dominic Jeffrey Haertling allows following entities to bill medicare on his behalf.
| Entity Name | Mercy Hospital Perry |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1063117158
PECOS PAC ID: 1153777826
Enrollment ID: O20231101001515 |
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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. Dominic Jeffrey Haertling 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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Dominic Jeffrey Haertling, MD
212 Hospital Ln Ste 202,
Perryville, MO 63775-4204
Ph: (573) 768-3449 | Dominic Jeffrey Haertling, MD
212 Hospital Ln Ste 202,
Perryville, MO 63775-4204
Ph: (573) 768-3449 |
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