Dr Matthew M Kershisnik, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Logan, Utah. His current practice location is
1400 N 500 E, Logan, Utah. You can reach out to his office (for appointments etc.) via phone at
(435) 716-5375.
Dr Matthew M Kershisnik is licensed to practice in Utah (license number 1831351205) 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 1851363600.
Physician's Profile
| Full Name | Dr Matthew M Kershisnik |
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| Gender | Male |
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| Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
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| Location | 1400 N 500 E, Logan, Utah |
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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: 1851363600
- Provider Enumeration Date: 02/06/2006
- Last Update Date: 04/20/2008
Medicare PECOS Information:
- PECOS PAC ID: 0042203044
- Enrollment ID: I20040406000606
Medical Identifiers
Medical identifiers for Dr Matthew M Kershisnik such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1851363600 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 1831351205 (Utah) | 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 Matthew M Kershisnik allows following entities to bill medicare on his behalf.
| Entity Name | Northern Utah Pathology Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053383141
PECOS PAC ID: 6800826660
Enrollment ID: O20050822000404 |
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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 Matthew M Kershisnik 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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Dr Matthew M Kershisnik, MD
Po Box 30309,
Charleston, SC 29417-0309
Ph: (843) 554-9300 | Dr Matthew M Kershisnik, MD
1400 N 500 E,
Logan, UT 84341-2455
Ph: (435) 716-5375 |
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