Edward Shackleford, DO - Medicare Emergency Medicine in Kenosha, WI

  1. Home
  2. Emergency Medicine
  3. WI
  4. Kenosha
Edward Shackleford, DO is a medicare enrolled "Emergency Medicine" physician in Kenosha, Wisconsin. His current practice location is 10400 75th St, Aurora Medical Center, Kenosha, Wisconsin. You can reach out to his office (for appointments etc.) via phone at (262) 697-7000.

Edward Shackleford is licensed to practice in Wisconsin (license number 42953021) 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 1790769800.

Contact Information

Edward Shackleford, DO
10400 75th St, Aurora Medical Center,
Kenosha, WI 53142-7884
(262) 697-7000
(630) 734-1560

Map and Direction




Physician's Profile

Full NameEdward Shackleford
GenderMale
SpecialityEmergency Medicine
Location10400 75th St, Kenosha, Wisconsin
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1790769800
  • Provider Enumeration Date: 12/01/2005
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 6608926399
  • Enrollment ID: I20090618000623

Medical Identifiers

Medical identifiers for Edward Shackleford such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1790769800NPI-NPPES
30099700MedicaidWI

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 42953021 (Wisconsin)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. Edward Shackleford allows following entities to bill medicare on his behalf.
Entity NameMercy Health System Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598718603
PECOS PAC ID: 7416860440
Enrollment ID: O20031113000164
Entity NameAspirus Riverview Hospital & Clinics Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1295754844
PECOS PAC ID: 4587658182
Enrollment ID: O20040414000945

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. Edward Shackleford 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 AddressPractice Location Address
Edward Shackleford, DO
Po Box 3043, Mea Aea Kenosh Sc,
Oak Brook, IL 60522-3043

Ph: (630) 734-0200		Edward Shackleford, DO
10400 75th St, Aurora Medical Center,
Kenosha, WI 53142-7884

Ph: (262) 697-7000

Reviews and Comments


Emergency Medicine Doctors in Kenosha, WI

David Eric Farkas, MD
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 10400 75th St, Aurora Medical Center, Kenosha, WI 53142
Phone: 262-697-7000    Fax: 630-734-1560
Ms. Kimberly Roberson, PA
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 10400 75th St, Kenosha, WI 53142
Phone: 262-948-5600    
Dr. Reena Meghan Underiner, MD
Emergency Medicine
Medicare: Medicare Enrolled
Practice Location: 10400 75th St, Kenosha, WI 53142
Phone: 262-948-5600    
Terry Zehr, MD
Emergency Medicine
Medicare: Not Enrolled in Medicare
Practice Location: 10400 75th St, Kenosha, WI 53142
Phone: 262-948-7000    
Manuel A. Rivera, M.D.
Emergency Medicine
Medicare: May Accept Medicare Assignments
Practice Location: 4536 22nd Ave, Kenosha, WI 53140
Phone: 262-656-0044    Fax: 262-653-2218
Mounica D Robinson, M.D.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 10400 75th St, Kenosha, WI 53142
Phone: 262-948-5600    
Benjamin A Feinzimer, D.O.
Emergency Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 6308 8th Ave, Kenosha, WI 53143
Phone: 414-290-6720    Fax: 414-290-6755

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.