Shisto Rais, is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Arlington, Texas. His current practice location is
3301 Matlock Rd, Arlington, Texas. You can reach out to his office (for appointments etc.) via phone at
(817) 247-3728.
Shisto Rais is licensed to practice in * (Not Available) (license number ) 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 1255960449.
Physician's Profile
Full Name | Shisto Rais |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 3301 Matlock Rd, Arlington, Texas |
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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: 1255960449
- Provider Enumeration Date: 04/08/2020
- Last Update Date: 12/05/2022
Medicare PECOS Information:
- PECOS PAC ID: 4880056043
- Enrollment ID: I20230821000583
Medical Identifiers
Medical identifiers for Shisto Rais such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1255960449 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | U0423 (Texas) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Shisto Rais allows following entities to bill medicare on his behalf.
Entity Name | Ess Of Fairfield Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1588132856 PECOS PAC ID: 9234475526 Enrollment ID: O20190108000545 |
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Entity Name | Hcc Of Fairfield Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1487122750 PECOS PAC ID: 3072859099 Enrollment ID: O20190114000163 |
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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. Shisto Rais 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 |
Shisto Rais, 3301 Matlock Rd, Arlington, TX 76015-2908 Ph: () - | Shisto Rais, 3301 Matlock Rd, Arlington, TX 76015-2908 Ph: (817) 247-3728 |
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