Dr Justin Peter Bandino, MD is a medicare enrolled "Dermatology" physician in Scott Air Force Base, Illinois. His current practice location is
310 W Losey St, Scott Air Force Base, Illinois. You can reach out to his office (for appointments etc.) via phone at
(210) 580-4475.
Dr Justin Peter Bandino is licensed to practice in Texas (license number R3796) 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 1780828863.
Physician's Profile
| Full Name | Dr Justin Peter Bandino |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 310 W Losey St, Scott Air Force Base, Illinois |
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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: 1780828863
- Provider Enumeration Date: 04/21/2009
- Last Update Date: 08/29/2024
Medicare PECOS Information:
- PECOS PAC ID: 1759699432
- Enrollment ID: I20170811000256
Medical Identifiers
Medical identifiers for Dr Justin Peter Bandino such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1780828863 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207ND0900X | Dermatology - Dermatopathology | R3796 (Texas) | Secondary |
| 207N00000X | Dermatology | R3796 (Texas) | 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 Justin Peter Bandino allows following entities to bill medicare on his behalf.
| Entity Name | Village Oaks Pathology Services, P.a. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730138397
PECOS PAC ID: 5597754507
Enrollment ID: O20040506000871 |
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| Entity Name | Sonterra Dermatology Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1285925966
PECOS PAC ID: 5193972859
Enrollment ID: O20120831000104 |
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| Entity Name | Epiphany Dermatology Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1043615263
PECOS PAC ID: 3971827791
Enrollment ID: O20150126001498 |
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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 Justin Peter Bandino 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 Justin Peter Bandino, MD
310 W Losey St,
Scott Air Force Base, IL 62225-5250
Ph: (210) 580-4475 | Dr Justin Peter Bandino, MD
310 W Losey St,
Scott Air Force Base, IL 62225-5250
Ph: (210) 580-4475 |
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