Dr David J Penn, MD is a medicare enrolled "Family Medicine" physician in Carbondale, Kansas. His current practice location is
211 E Main St, Carbondale, Kansas. You can reach out to his office (for appointments etc.) via phone at
(785) 836-7111.
Dr David J Penn is licensed to practice in Kansas (license number 04-24443) 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 1295775922.
Physician's Profile
| Full Name | Dr David J Penn |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 211 E Main St, Carbondale, Kansas |
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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: 1295775922
- Provider Enumeration Date: 06/08/2006
- Last Update Date: 06/09/2014
Medicare PECOS Information:
- PECOS PAC ID: 8628106754
- Enrollment ID: I20100512000098
Medical Identifiers
Medical identifiers for Dr David J Penn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1295775922 | NPI | - | NPPES |
| 067059 | Other | KS | MEDICARE PTAN |
| 100159180B | Medicaid | KS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 04-24443 (Kansas) | 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 J Penn allows following entities to bill medicare on his behalf.
| Entity Name | Cotton O'neil Clinic Revocable Trust |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1811944457
PECOS PAC ID: 5496659195
Enrollment ID: O20031124000674 |
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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 J Penn 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 J Penn, MD
211 E Main St,
Carbondale, KS 66414-9607
Ph: (785) 836-7111 | Dr David J Penn, MD
211 E Main St,
Carbondale, KS 66414-9607
Ph: (785) 836-7111 |
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