Dr Shelly Bansal, MD is a medicare enrolled "Thoracic Surgery (cardiothoracic Vascular Surgery)" physician in Saint Joseph, Missouri. Her current practice location is
802 N Riverside Rd Ste 210, Saint Joseph, Missouri. You can reach out to her office (for appointments etc.) via phone at
(816) 271-6200.
Dr Shelly Bansal is licensed to practice in Ohio (license number 35.096003) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1174793111.
Physician's Profile
| Full Name | Dr Shelly Bansal |
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| Gender | Female |
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| Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
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| Location | 802 N Riverside Rd Ste 210, Saint Joseph, Missouri |
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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: 1174793111
- Provider Enumeration Date: 03/05/2008
- Last Update Date: 05/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 4688801806
- Enrollment ID: I20150302000881
Medical Identifiers
Medical identifiers for Dr Shelly Bansal such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1174793111 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 2022044341 (Missouri) | Secondary |
| 208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 35.096003 (Ohio) | 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 Shelly Bansal allows following entities to bill medicare on her behalf.
| Entity Name | Mayo Clinic Health System In Waycross, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154745982
PECOS PAC ID: 0042124919
Enrollment ID: O20040308000639 |
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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 Shelly Bansal 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 Shelly Bansal, MD
445 N Silverbell Rd Ste 201,
Tucson, AZ 85745-2686
Ph: (520) 396-1370 | Dr Shelly Bansal, MD
802 N Riverside Rd Ste 210,
Saint Joseph, MO 64507-2509
Ph: (816) 271-6200 |
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