Garrett Shackleton, MD is a medicare enrolled "Colon & Rectal Surgery" physician in Colorado Springs, Colorado. His current practice location is
1400 E Boulder St Ste 500, Colorado Springs, Colorado. You can reach out to his office (for appointments etc.) via phone at
(719) 364-6487.
Garrett Shackleton is licensed to practice in Colorado (license number DR.0069230) 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 1295183184.
Physician's Profile
Full Name | Garrett Shackleton |
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Gender | Male |
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Speciality | Colon & Rectal Surgery |
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Location | 1400 E Boulder St Ste 500, Colorado Springs, Colorado |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1295183184
- Provider Enumeration Date: 06/01/2016
- Last Update Date: 08/19/2022
Medicare PECOS Information:
- PECOS PAC ID: 6608160411
- Enrollment ID: I20220908003380
Medical Identifiers
Medical identifiers for Garrett Shackleton such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1295183184 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 125.068578 (Illinois) | Secondary |
208C00000X | Colon & Rectal Surgery | DR.0069230 (Colorado) | 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. Garrett Shackleton allows following entities to bill medicare on his behalf.
Entity Name | Poudre Valley Medical Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366763260 PECOS PAC ID: 9638208549 Enrollment ID: O20100602000122 |
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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. Garrett Shackleton 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 |
Garrett Shackleton, MD 2695 Rocky Mountain Ave Ste 150, Loveland, CO 80538-9071 Ph: (970) 624-2412 | Garrett Shackleton, MD 1400 E Boulder St Ste 500, Colorado Springs, CO 80909-5533 Ph: (719) 364-6487 |
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