Kenneth Gene Sebrero Lacandazo, PT is a medicare enrolled "Physical Medicine & Rehabilitation" physician in Monteagle, Tennessee. His current practice location is
26 2nd St, Monteagle, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(932) 924-2041.
Kenneth Gene Sebrero Lacandazo is licensed to practice in Tennessee (license number 11420) 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 1093335812.
Physician's Profile
| Full Name | Kenneth Gene Sebrero Lacandazo |
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| Gender | Male |
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| Speciality | Physical Medicine & Rehabilitation |
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| Location | 26 2nd St, Monteagle, Tennessee |
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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: 1093335812
- Provider Enumeration Date: 04/22/2020
- Last Update Date: 04/22/2020
Medicare PECOS Information:
- PECOS PAC ID: 6507308913
- Enrollment ID: I20240612002930
Medical Identifiers
Medical identifiers for Kenneth Gene Sebrero Lacandazo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1093335812 | NPI | - | NPPES |
| 137911973 | Other | TN | DRIVER'S LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208100000X | Physical Medicine & Rehabilitation | 11420 (Tennessee) | 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. Kenneth Gene Sebrero Lacandazo allows following entities to bill medicare on his behalf.
| Entity Name | Healthpro Heritage Rehab & Fitness Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376073262
PECOS PAC ID: 6507832573
Enrollment ID: O20171003005084 |
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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. Kenneth Gene Sebrero Lacandazo 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 |
|---|
Kenneth Gene Sebrero Lacandazo, PT
26 2nd St,
Monteagle, TN 37356-7415
Ph: () - | Kenneth Gene Sebrero Lacandazo, PT
26 2nd St,
Monteagle, TN 37356-7415
Ph: (932) 924-2041 |
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