Sean M Faris, MD is a medicare enrolled "Pediatrics" physician in Mukwonago, Wisconsin. His current practice location is
240 Maple Avenue, Prohealth Care Medical Associates Inc., Mukwonago, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(262) 928-1900.
Sean M Faris is licensed to practice in Wisconsin (license number 44055) 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 1235102286.
Physician's Profile
Full Name | Sean M Faris |
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Gender | Male |
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Speciality | Pediatrics |
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Location | 240 Maple Avenue, Mukwonago, Wisconsin |
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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: 1235102286
- Provider Enumeration Date: 02/09/2006
- Last Update Date: 11/09/2011
Medicare PECOS Information:
- PECOS PAC ID: 6103092788
- Enrollment ID: I20120103000397
Medical Identifiers
Medical identifiers for Sean M Faris such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1235102286 | NPI | - | NPPES |
34158400 | Medicaid | WI | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208000000X | Pediatrics | 44055 (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. Sean M Faris allows following entities to bill medicare on his behalf.
Entity Name | Prohealth Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1356322440 PECOS PAC ID: 3476465188 Enrollment ID: O20031103000066 |
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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. Sean M Faris 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 |
Sean M Faris, MD N17 W24100 Riverwood Drive Suite 250, Prohealth Care Medical Associates Inc, Waukesha, WI 53188-1177 Ph: (262) 928-4100 | Sean M Faris, MD 240 Maple Avenue, Prohealth Care Medical Associates Inc., Mukwonago, WI 53149 Ph: (262) 928-1900 |
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