Shane Thomas Bealer, DO is a medicare enrolled "Family Medicine - Sports Medicine" physician in Rock Hill, New York. His current practice location is
61 Emerald Pl, Rock Hill, New York. You can reach out to his office (for appointments etc.) via phone at
(845) 703-6999.
Shane Thomas Bealer is licensed to practice in New York (license number 329923) 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 1154941409.
Physician's Profile
| Full Name | Shane Thomas Bealer |
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| Gender | Male |
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| Speciality | Family Medicine - Sports Medicine |
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| Location | 61 Emerald Pl, Rock Hill, New York |
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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: 1154941409
- Provider Enumeration Date: 04/16/2020
- Last Update Date: 06/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 7214350784
- Enrollment ID: I20240617003586
Medical Identifiers
Medical identifiers for Shane Thomas Bealer such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1154941409 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | OT019811 (Pennsylvania) | Secondary |
| 207Q00000X | Family Medicine | 329923 (New York) | Secondary |
| 207QS0010X | Family Medicine - Sports Medicine | 329923 (New York) | 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 Thomas Bealer allows following entities to bill medicare on his behalf.
| Entity Name | Crystal Run Healthcare Physicians Llp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1952376410
PECOS PAC ID: 6901792696
Enrollment ID: O20040227000791 |
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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 Thomas Bealer 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 Thomas Bealer, DO
155 Crystal Run Rd,
Middletown, NY 10941-4057
Ph: (845) 703-6999 | Shane Thomas Bealer, DO
61 Emerald Pl,
Rock Hill, NY 12775-6049
Ph: (845) 703-6999 |
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