Dr David Allen South, MD is a medicare enrolled "Dermatology" physician in Freedom, California. His current practice location is
204 Green Valley Road, Freedom, California. You can reach out to his office (for appointments etc.) via phone at
(831) 728-2005.
Dr David Allen South is licensed to practice in California (license number G30108) 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 1053470468.
Physician's Profile
| Full Name | Dr David Allen South |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 204 Green Valley Road, Freedom, California |
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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: 1053470468
- Provider Enumeration Date: 12/08/2006
- Last Update Date: 06/05/2009
Medicare PECOS Information:
- PECOS PAC ID: 5092861039
- Enrollment ID: I20090916000763
Medical Identifiers
Medical identifiers for Dr David Allen South such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053470468 | NPI | - | NPPES |
| 00G301080 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | G30108 (California) | 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. Dr David Allen South allows following entities to bill medicare on his behalf.
| Entity Name | Csi Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1871909804
PECOS PAC ID: 5890916845
Enrollment ID: O20141016001930 |
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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 David Allen South 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 David Allen South, MD
204 Green Valley Road,
Freedom, CA 95019
Ph: (831) 728-2005 | Dr David Allen South, MD
204 Green Valley Road,
Freedom, CA 95019
Ph: (831) 728-2005 |
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