Kenneth Trevor Shealy, OD in Tifton, GA - Medicare Optometry Provider

Kenneth Trevor Shealy, OD is a medicare enrolled "Optometrist" provider in Tifton, Georgia. He went to Southern College Of Optometry and graduated in 2020 and has 4 years of diverse experience with area of expertise as Optometry. He is a member of the group practice Tift Regional Health System Inc and his current practice location is 1803 Old Ocilla Rd, Tifton, Georgia. You can reach out to his office (for appointments etc.) via phone at (229) 386-2181.

Kenneth Trevor Shealy is licensed to practice in Georgia (license number OPT003252) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1104436922.

Contact Information

	Kenneth Trevor Shealy, OD
	1803 Old Ocilla Rd, Tifton, GA 31794-1617
	(229) 386-2181
	(229) 386-2193

Map and Direction

Healthcare Provider's Profile

Full Name	Kenneth Trevor Shealy
Gender	Male
Speciality	Optometry
Experience	4 Years
Location	1803 Old Ocilla Rd, Tifton, Georgia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Kenneth Trevor Shealy attended and graduated from Southern College Of Optometry in 2020

NPI Data:

NPI Number: 1104436922
Provider Enumeration Date: 08/06/2020
Last Update Date: 08/23/2024

Medicare PECOS Information:

PECOS PAC ID: 7618388570
Enrollment ID: I20201124003123

Medical Identifiers

Medical identifiers for Kenneth Trevor Shealy such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104436922	NPI	-	NPPES
OPT003252	Other	GA	OPTOMETRY LICENSE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
152W00000X	Optometrist	OPT003252 (Georgia)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Tift Regional Health System Inc	2062745169	278

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. Kenneth Trevor Shealy allows following entities to bill medicare on his behalf.

Provider Name	Fitzgerald Family Eyecare, P.c.
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1114938727 PECOS PAC ID: 5193762912 Enrollment ID: O20050413000816

Provider Name	Tift Regional Health System Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1881203305 PECOS PAC ID: 2062745169 Enrollment ID: O20200217002409

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. Kenneth Trevor Shealy 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
Kenneth Trevor Shealy, OD 1803 Old Ocilla Rd, Tifton, GA 31794-1617 Ph: (229) 386-2181	Kenneth Trevor Shealy, OD 1803 Old Ocilla Rd, Tifton, GA 31794-1617 Ph: (229) 386-2181

Reviews and Comments

Optometrist in Tifton, GA

South Georgia Eye Partners Optometrist Medicare: Not Enrolled in Medicare Practice Location: 416 Tift Ave N, Tifton, GA 31794 Phone: 229-391-4180 Fax: 229-391-2929
Janine Tran Nguyen, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2012 Pineview Ave, Tifton, GA 31794 Phone: 229-382-4765 Fax: 229-382-4819
South Georgia Eye Partners Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 416 Tift Ave N, Tifton, GA 31794 Phone: 229-391-4180 Fax: 229-391-2929
Michael J Garner Od Pc Optometrist Medicare: Not Enrolled in Medicare Practice Location: 1830 Hwy 82 W, Tifton, GA 31793 Phone: 229-387-8863
Dr. Ted A Mcelroy, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2012 Pineview Ave, Tifton, GA 31794 Phone: 229-382-4765 Fax: 229-382-4819
Vision Source Tifton Optometrist Medicare: Medicare Enrolled Practice Location: 2012 Pineview Ave, Tifton, GA 31794 Phone: 229-382-4765 Fax: 229-382-4819

Kenneth Trevor Shealy, OD - Medicare Optometrist in Tifton, GA