Dr William Randolph Fly, MD is a medicare enrolled "Orthopaedic Surgery" physician in Jefferson City, Tennessee. He graduated from medical school in 1983 and has 41 years of diverse experience with area of expertise as Orthopedic Surgery. He is a member of the group practice Orthotennessee, Pc, Volunteer Healthcare Services, Inc. and his current practice location is
120 Hospital Dr, Suite 250, Jefferson City, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(865) 475-4484.
Dr William Randolph Fly is licensed to practice in Tennessee (license number 15794) 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 1063473346.
Physician's Profile
| Full Name | Dr William Randolph Fly |
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| Gender | Male |
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| Speciality | Orthopedic Surgery |
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| Experience | 41 Years |
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| Location | 120 Hospital Dr, Jefferson City, Tennessee |
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| Accepts Medicare Assignments | Yes. He 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 William Randolph Fly graduated from medical school in 1983
NPI Data:
- NPI Number: 1063473346
- Provider Enumeration Date: 03/28/2006
- Last Update Date: 06/20/2017
Medicare PECOS Information:
- PECOS PAC ID: 5496871345
- Enrollment ID: I20100928001208
Medical Identifiers
Medical identifiers for Dr William Randolph Fly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1063473346 | NPI | - | NPPES |
| P01315239 | Other | TN | RAILROAD MEDICARE |
| Q001842 | Medicaid | TN | |
| 2577295 | Other | | CIGNA |
| 200046272 | Other | GA | RAILROAD MEDICARE |
| 6004897 | Other | TN | BLUECROSS BLUESHIELD |
| 7962437 | Other | TN | AETNA |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207X00000X | Orthopaedic Surgery | 15794 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Orthotennessee, Pc | 3476453572 | 162 |
| Volunteer Healthcare Services, Inc. | 8820003981 | 34 |
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 William Randolph Fly allows following entities to bill medicare on his behalf.
| Entity Name | Orthotennessee, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1518049592
PECOS PAC ID: 3476453572
Enrollment ID: O20040113000622 |
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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 William Randolph Fly 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 William Randolph Fly, MD
120 Hospital Dr, Suite 250,
Jefferson City, TN 37760-5287
Ph: (865) 475-4484 | Dr William Randolph Fly, MD
120 Hospital Dr, Suite 250,
Jefferson City, TN 37760-5287
Ph: (865) 475-4484 |
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