Excelsior Podiatry Clinic Pllc is a medicare enrolled "Podiatrist - Foot & Ankle Surgery" provider in Somerville, Tennessee. Their current practice location is
214 Lakeview Rd, Somerville, Tennessee. You can reach out to their office (for appointments etc.) via phone at
(901) 516-4005.
Excelsior Podiatry Clinic Pllc is licensed to practice in Tennessee (license number DPM0000000649) and it also participates in the medicare program. Excelsior Podiatry Clinic Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1003085515.
Healthcare Provider's Profile
| Full Name | Excelsior Podiatry Clinic Pllc |
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| Type | Facility |
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| Speciality | Podiatrist - Foot & Ankle Surgery |
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| Location | 214 Lakeview Rd, Somerville, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1003085515
- Provider Enumeration Date: 02/28/2008
- Last Update Date: 04/13/2010
Medicare PECOS Information:
- PECOS PAC ID: 3274602115
- Enrollment ID: O20080519000768
Medical Identifiers
Medical identifiers for Excelsior Podiatry Clinic Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003085515 | NPI | - | NPPES |
| 33542121 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213ES0103X | Podiatrist - Foot & Ankle Surgery | DPM0000000649 (Tennessee) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Excelsior Podiatry Clinic Pllc acts as a billing entity for following providers:
| Provider Name | John Elijah Bell |
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| Provider Type | Practitioner - Podiatry |
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| Provider Identifiers | NPI Number: 1871525253
PECOS PAC ID: 9830112853
Enrollment ID: I20060105000233 |
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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. Excelsior Podiatry Clinic Pllc 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 |
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Excelsior Podiatry Clinic Pllc
Po Box 460,
Oakland, TN 38060-0460
Ph: (901) 516-4005 | Excelsior Podiatry Clinic Pllc
214 Lakeview Rd,
Somerville, TN 38068-9737
Ph: (901) 516-4005 |
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