Keerthi Bansal, is a medicare enrolled "Allergy & Immunology" physician in Sioux Falls, South Dakota. Her current practice location is
1321 W 22nd St, Sioux Falls, South Dakota. You can reach out to her office (for appointments etc.) via phone at
(605) 404-4000.
Keerthi Bansal is licensed to practice in South Dakota (license number 15364) 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 1053814863.
Physician's Profile
| Full Name | Keerthi Bansal |
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| Gender | Female |
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| Speciality | Allergy & Immunology |
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| Location | 1321 W 22nd St, Sioux Falls, South Dakota |
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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: 1053814863
- Provider Enumeration Date: 03/18/2018
- Last Update Date: 08/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 9739429945
- Enrollment ID: I20240830002484
Medical Identifiers
Medical identifiers for Keerthi Bansal such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053814863 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207K00000X | Allergy & Immunology | 036.160246 (Illinois) | Secondary |
| 207K00000X | Allergy & Immunology | 15364 (South Dakota) | 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. Keerthi Bansal allows following entities to bill medicare on her behalf.
| Entity Name | Sanford Medical Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093090342
PECOS PAC ID: 8325950215
Enrollment ID: O20040115000388 |
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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. Keerthi 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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Keerthi Bansal,
Po Box 5074,
Sioux Falls, SD 57117-5074
Ph: () - | Keerthi Bansal,
1321 W 22nd St,
Sioux Falls, SD 57105-1502
Ph: (605) 404-4000 |
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