Shane Lavin, is a medicare enrolled "Preventive Medicine - Occupational Medicine" physician in Petaluma, California. His current practice location is
3900 Lakeville Hwy, Mob-2, Petaluma, California. You can reach out to his office (for appointments etc.) via phone at
(707) 765-3800.
Shane Lavin is licensed to practice in California (license number 178185) 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 1538584982.
Physician's Profile
| Full Name | Shane Lavin |
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| Gender | Male |
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| Speciality | Preventive Medicine - Occupational Medicine |
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| Location | 3900 Lakeville Hwy, Petaluma, California |
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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: 1538584982
- Provider Enumeration Date: 02/21/2014
- Last Update Date: 08/11/2022
Medicare PECOS Information:
- PECOS PAC ID: 8325424823
- Enrollment ID: I20221006002901
Medical Identifiers
Medical identifiers for Shane Lavin such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538584982 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 2083X0100X | Preventive Medicine - Occupational Medicine | 178185 (California) | 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 Lavin allows following entities to bill medicare on his behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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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 Lavin 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 |
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Shane Lavin,
620 John Paul Jones Cir,
Portsmouth, VA 23708-2111
Ph: (757) 953-2518 | Shane Lavin,
3900 Lakeville Hwy, Mob-2,
Petaluma, CA 94954
Ph: (707) 765-3800 |
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