Shannon Elisa Heffernan, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Fresno, California. Her current practice location is
155 N Fresno St, Fresno, California. You can reach out to her office (for appointments etc.) via phone at
(559) 499-6400.
Shannon Elisa Heffernan is licensed to practice in * (Not Available) (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1023697679.
Physician's Profile
Full Name | Shannon Elisa Heffernan |
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Gender | Female |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 155 N Fresno St, Fresno, California |
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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: 1023697679
- Provider Enumeration Date: 04/02/2021
- Last Update Date: 03/28/2024
Medicare PECOS Information:
- PECOS PAC ID: 0042612178
- Enrollment ID: I20210713001138
Medical Identifiers
Medical identifiers for Shannon Elisa Heffernan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1023697679 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | 81155 (Wisconsin) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
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. Shannon Elisa Heffernan 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 |
Shannon Elisa Heffernan, MD 155 N Fresno St, Fresno, CA 93701-2302 Ph: () - | Shannon Elisa Heffernan, MD 155 N Fresno St, Fresno, CA 93701-2302 Ph: (559) 499-6400 |
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