Dr Sally A Booth, MD is a medicare enrolled "Dermatology" physician in Zionsville, Indiana. She went to University Of Minnesota Medical School and graduated in 1990 and has 35 years of diverse experience with area of expertise as Dermatology. She is a member of the group practice Booth Dermatology Group, Pc and her current practice location is
12050 N Michigan Rd, Zionsville, Indiana. You can reach out to her office (for appointments etc.) via phone at
(317) 848-2427.
Dr Sally A Booth is licensed to practice in Indiana (license number 01042816A) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1669452884.
Physician's Profile
| Full Name | Dr Sally A Booth |
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| Gender | Female |
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| Speciality | Dermatology |
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| Experience | 35 Years |
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| Location | 12050 N Michigan Rd, Zionsville, Indiana |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Sally A Booth attended and graduated from University Of Minnesota Medical School in 1990
NPI Data:
- NPI Number: 1669452884
- Provider Enumeration Date: 01/23/2006
- Last Update Date: 01/26/2021
Medicare PECOS Information:
- PECOS PAC ID: 0446289524
- Enrollment ID: I20050809000616
Medical Identifiers
Medical identifiers for Dr Sally A Booth such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1669452884 | NPI | - | NPPES |
| 000000375169 | Other | IN | ANTHEM PIN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | ME142799 (Florida) | Secondary |
| 207ND0101X | Dermatology - Mohs-micrographic Surgery | 01042816A (Indiana) | Secondary |
| 207NS0135X | Dermatology - Procedural Dermatology | 01042816A (Indiana) | Secondary |
| 207N00000X | Dermatology | 01042816A (Indiana) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Booth Dermatology Group, Pc | 2860426574 | 2 |
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 Sally A Booth allows following entities to bill medicare on her behalf.
| Entity Name | Booth Dermatology Group, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1346220563
PECOS PAC ID: 2860426574
Enrollment ID: O20050922000261 |
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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 Sally A Booth 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 Sally A Booth, MD
12050 N Michigan Rd,
Zionsville, IN 46077-8782
Ph: (317) 848-2427 | Dr Sally A Booth, MD
12050 N Michigan Rd,
Zionsville, IN 46077-8782
Ph: (317) 848-2427 |
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