Loyal Shane Farley, DO is a medicare enrolled "General Practice" physician in Wasilla, Alaska. His current practice location is
950 E Bogard Rd Ste 103, Wasilla, Alaska. You can reach out to his office (for appointments etc.) via phone at
(907) 352-2880.
Loyal Shane Farley is licensed to practice in Alaska (license number 192430) 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 1659930006.
Physician's Profile
Full Name | Loyal Shane Farley |
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Gender | Male |
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Speciality | General Practice |
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Location | 950 E Bogard Rd Ste 103, Wasilla, Alaska |
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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: 1659930006
- Provider Enumeration Date: 06/10/2019
- Last Update Date: 08/13/2023
Medicare PECOS Information:
- PECOS PAC ID: 3375901002
- Enrollment ID: I20230628000029
Medical Identifiers
Medical identifiers for Loyal Shane Farley such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1659930006 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | 192430 (Alaska) | Secondary |
208D00000X | General Practice | 192430 (Alaska) | 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. Loyal Shane Farley allows following entities to bill medicare on his behalf.
Entity Name | Mat Su Valley Medical Center Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1912950148 PECOS PAC ID: 5698686475 Enrollment ID: O20040123000583 |
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Entity Name | Matsu Emergency Medicine Physicians Corp |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073548129 PECOS PAC ID: 1557251022 Enrollment ID: O20040318000130 |
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Entity Name | Mat-su Valley Iii Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366752560 PECOS PAC ID: 5496941502 Enrollment ID: O20101130001385 |
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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. Loyal Shane Farley 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 |
Loyal Shane Farley, DO 307 Grizzly Trl, Harker Heights, TX 76548-5628 Ph: () - | Loyal Shane Farley, DO 950 E Bogard Rd Ste 103, Wasilla, AK 99654-7184 Ph: (907) 352-2880 |
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