Dr Roland Spurgeon Beverly Iii, MD is a medicare enrolled "Dermatology" physician in Aliso Viejo, California. His current practice location is
24541 Pacific Park Dr, Suite 103, Aliso Viejo, California. You can reach out to his office (for appointments etc.) via phone at
(949) 831-3057.
Dr Roland Spurgeon Beverly Iii is licensed to practice in California (license number G65658) 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 1083687776.
Physician's Profile
| Full Name | Dr Roland Spurgeon Beverly Iii |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 24541 Pacific Park Dr, Aliso Viejo, 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: 1083687776
- Provider Enumeration Date: 02/11/2006
- Last Update Date: 05/10/2017
Medicare PECOS Information:
- PECOS PAC ID: 0345139739
- Enrollment ID: I20081201000667
Medical Identifiers
Medical identifiers for Dr Roland Spurgeon Beverly Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1083687776 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | G65658 (California) | Primary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | G65658 (California) | Secondary |
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 Roland Spurgeon Beverly Iii allows following entities to bill medicare on his behalf.
| Entity Name | J Robert West Md Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1932154788
PECOS PAC ID: 8729990973
Enrollment ID: O20031105000239 |
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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 Roland Spurgeon Beverly Iii 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 Roland Spurgeon Beverly Iii, MD
24541 Pacific Park Dr, Suite 103,
Aliso Viejo, CA 92656-3065
Ph: (949) 831-3057 | Dr Roland Spurgeon Beverly Iii, MD
24541 Pacific Park Dr, Suite 103,
Aliso Viejo, CA 92656-3065
Ph: (949) 831-3057 |
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