Dr Ralph Eugene Massullo Jr, MD is a medicare enrolled "Dermatology - Mohs-micrographic Surgery" physician in Lecanto, Florida. He went to West Virginia University School Of Medicine and graduated in 1985 and has 39 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Suncoast Skin Solutions and his current practice location is
525 N Dacie Pt, Lecanto, Florida. You can reach out to his office (for appointments etc.) via phone at
(352) 746-2200.
Dr Ralph Eugene Massullo Jr is licensed to practice in Florida (license number ME54469) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1104810563.
Physician's Profile
| Full Name | Dr Ralph Eugene Massullo Jr |
|---|
| Gender | Male |
|---|
| Speciality | Dermatology |
|---|
| Experience | 39 Years |
|---|
| Location | 525 N Dacie Pt, Lecanto, Florida |
|---|
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
|---|
Medical Education and Training:
- Dr Ralph Eugene Massullo Jr attended and graduated from West Virginia University School Of Medicine in 1985
NPI Data:
- NPI Number: 1104810563
- Provider Enumeration Date: 08/31/2005
- Last Update Date: 11/12/2022
Medicare PECOS Information:
- PECOS PAC ID: 6507822111
- Enrollment ID: I20100709000769
Medical Identifiers
Medical identifiers for Dr Ralph Eugene Massullo Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1104810563 | NPI | - | NPPES |
| 037329000 | Medicaid | FL | |
| 070002449 | Other | FL | SRRGA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207N00000X | Dermatology | ME54469 (Florida) | Secondary |
| 207ND0900X | Dermatology - Dermatopathology | ME54469 (Florida) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | ME54469 (Florida) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | ME54469 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Suncoast Skin Solutions | 7416018221 | 63 |
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 Ralph Eugene Massullo Jr allows following entities to bill medicare on his behalf.
| Entity Name | Suncoast Dermatology And Skin Surgery Center, Pa |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1902890239
PECOS PAC ID: 6305802919
Enrollment ID: O20041206000736 |
|---|
| Entity Name | Suncoast Skin Solutions |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1487827416
PECOS PAC ID: 7416018221
Enrollment ID: O20081211000112 |
|---|
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 Ralph Eugene Massullo Jr 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 Ralph Eugene Massullo Jr, MD
4651 Van Dyke Rd,
Lutz, FL 33558-4880
Ph: (813) 321-1786 | Dr Ralph Eugene Massullo Jr, MD
525 N Dacie Pt,
Lecanto, FL 34461-8399
Ph: (352) 746-2200 |
Reviews and Comments