Laurel J Shambo, PA is a medicare enrolled "Physician Assistant" in Copenhagen, New York. Her current practice location is
9732 State Route 12, Copenhagen, New York. You can reach out to her office (for appointments etc.) via phone at
(315) 688-2305.
Laurel J Shambo is licensed to practice in New York (license number 015328) 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 1871881649.
Provider's Profile
| Full Name | Laurel J Shambo |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 9732 State Route 12, Copenhagen, 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: 1871881649
- Provider Enumeration Date: 07/14/2011
- Last Update Date: 03/08/2012
Medicare PECOS Information:
- PECOS PAC ID: 9830356971
- Enrollment ID: I20120201000718
Medical Identifiers
Medical identifiers for Laurel J Shambo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1871881649 | NPI | - | NPPES |
| 03417452 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 015328 (New York) | Primary |
| 363A00000X | Physician Assistant | P80534 (New York) | Secondary |
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. Laurel J Shambo 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 |
|---|
Laurel J Shambo, PA
Po Box 2337,
Syracuse, NY 13220-2337
Ph: (315) 701-5607 | Laurel J Shambo, PA
9732 State Route 12,
Copenhagen, NY 13626-2906
Ph: (315) 688-2305 |
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