Shane Douglas Reynal, is a medicare enrolled "Dermatology" physician in Live Oak, Texas. His current practice location is
7832 Pat Booker Rd, Live Oak, Texas. You can reach out to his office (for appointments etc.) via phone at
(210) 657-9338.
Shane Douglas Reynal is licensed to practice in Texas (license number U2302) 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 1831651181.
Physician's Profile
| Full Name | Shane Douglas Reynal |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 7832 Pat Booker Rd, Live Oak, Texas |
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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: 1831651181
- Provider Enumeration Date: 04/04/2019
- Last Update Date: 08/21/2023
Medicare PECOS Information:
- PECOS PAC ID: 7517200918
- Enrollment ID: I20230609000105
Medical Identifiers
Medical identifiers for Shane Douglas Reynal such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1831651181 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | U2302 (Texas) | 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 Douglas Reynal allows following entities to bill medicare on his behalf.
| Entity Name | Dermatology Associates Of San Antonio |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1487661518
PECOS PAC ID: 1759319296
Enrollment ID: O20050727000312 |
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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. Shane Douglas Reynal 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 Douglas Reynal,
7832 Pat Booker Rd,
Live Oak, TX 78233-2601
Ph: (210) 657-9338 | Shane Douglas Reynal,
7832 Pat Booker Rd,
Live Oak, TX 78233-2601
Ph: (210) 657-9338 |
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