Shane Brent Goller, MD in Tacoma, WA - Medicare Emergency Medicine

Shane Brent Goller, MD is a medicare enrolled "Emergency Medicine" physician in Tacoma, Washington. His current practice location is 9040 Jackson Ave, Tacoma, Washington. You can reach out to his office (for appointments etc.) via phone at (253) 477-0838.

Shane Brent Goller is licensed to practice in Virginia (license number 0101265466) 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 1487188652.

Contact Information

	Shane Brent Goller, MD
	9040 Jackson Ave, Tacoma, WA 98431-1100
	(253) 477-0838
	Not Available

Map and Direction

Physician's Profile

Full Name	Shane Brent Goller
Gender	Male
Speciality	Emergency Medicine
Location	9040 Jackson Ave, Tacoma, Washington
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1487188652
Provider Enumeration Date: 04/14/2017
Last Update Date: 10/25/2023

Medicare PECOS Information:

PECOS PAC ID: 1759702467
Enrollment ID: I20240221000248

Medical Identifiers

Medical identifiers for Shane Brent Goller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1487188652	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208D00000X	General Practice	0101265466 (Virginia)	Secondary
207P00000X	Emergency Medicine	0101265466 (Virginia)	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. Shane Brent Goller allows following entities to bill medicare on his behalf.

Entity Name	Northwest Emergency Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1235172370 PECOS PAC ID: 3476462334 Enrollment ID: O20041214000892

Entity Name	Northwest Observation Associates Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1023539376 PECOS PAC ID: 9032480942 Enrollment ID: O20170810000470

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. Shane Brent Goller 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
Shane Brent Goller, MD 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1101 Ph: (253) 968-1110	Shane Brent Goller, MD 9040 Jackson Ave, Tacoma, WA 98431-1100 Ph: (253) 477-0838

Reviews and Comments

Emergency Medicine Doctors in Tacoma, WA

Dr. Justin Cha-cheng Ng, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-403-2050
Robert F Wachtel, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-403-1000
Dr. Nathan Kinneer Friedline, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 9040 Jackson Ave, Tacoma, WA 98433 Phone: 850-885-2273
Barbara Sherry Mezger, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 209 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-596-3400 Fax: 253-596-3301
Dr. Peter Stull, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: Madigan Army Medical Center 9040 Jackson Ave, Tacoma, WA 98431 Phone: 253-968-1250 Fax: 253-968-2550
Kevin E Callahan, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 315 Martin Luther King Jr Way, Tacoma, WA 98405 Phone: 253-403-1000
June A Burn, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 14815 Pacific Ave S, Tacoma, WA 98444 Phone: 253-697-8660

Shane Brent Goller, MD - Medicare Emergency Medicine in Tacoma, WA