Dr Charles C Southerland, DPM is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Eagle Mountain, Utah. His current practice location is
3435 E Pony Express Pkwy Ste 140, Eagle Mountain, Utah. You can reach out to his office (for appointments etc.) via phone at
(801) 893-8811.
Dr Charles C Southerland is licensed to practice in Utah (license number 9244891-0501) 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 1306832944.
Healthcare Provider's Profile
| Full Name | Dr Charles C Southerland |
|---|
| Gender | Male |
|---|
| Speciality | Podiatrist - Foot & Ankle Surgery |
|---|
| Location | 3435 E Pony Express Pkwy Ste 140, Eagle Mountain, Utah |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1306832944
- Provider Enumeration Date: 09/20/2005
- Last Update Date: 04/24/2020
Medicare PECOS Information:
- PECOS PAC ID: 3678744364
- Enrollment ID: I20110929000653
Medical Identifiers
Medical identifiers for Dr Charles C Southerland such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306832944 | NPI | - | NPPES |
| 9244891-0501 | Other | UT | MEDICAL LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 213ES0103X | Podiatrist - Foot & Ankle Surgery | 9244891-0501 (Utah) | 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. Dr Charles C Southerland allows following entities to bill medicare on his behalf.
| Provider Name | Barry University Inc |
|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
|---|
| Provider Identifiers | NPI Number: 1295959625
PECOS PAC ID: 3870499718
Enrollment ID: O20031210000902 |
|---|
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. Dr Charles C Southerland 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 |
|---|
Dr Charles C Southerland, DPM
11300 Ne 2nd Avenue,
Miami Shores, FL 33161
Ph: (305) 693-7287 | Dr Charles C Southerland, DPM
3435 E Pony Express Pkwy Ste 140,
Eagle Mountain, UT 84005-5548
Ph: (801) 893-8811 |
Reviews and Comments