Shade Raymond Preston Iv, DO - Medicare Anesthesiology in Augusta, GA

Shade Raymond Preston Iv, DO is a medicare enrolled "Anesthesiology" physician in Augusta, Georgia. He went to West Virginia School Of Osteopathic Medicine and graduated in 2003 and has 21 years of diverse experience with area of expertise as Anesthesiology. He is a member of the group practice Piedmont Anesthesia Llc and his current practice location is 1350 Walton Way, Augusta, Georgia. You can reach out to his office (for appointments etc.) via phone at (706) 737-9250.

Shade Raymond Preston Iv is licensed to practice in Georgia (license number 058811) 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 1053431635.

Contact Information

Shade Raymond Preston Iv, DO
1350 Walton Way,
Augusta, GA 30901-2612
(706) 737-9250
(706) 733-0697



Physician's Profile

Full NameShade Raymond Preston Iv
GenderMale
SpecialityAnesthesiology
Experience21 Years
Location1350 Walton Way, Augusta, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Shade Raymond Preston Iv attended and graduated from West Virginia School Of Osteopathic Medicine in 2003
  NPI Data:
  • NPI Number: 1053431635
  • Provider Enumeration Date: 03/29/2007
  • Last Update Date: 06/16/2008
  Medicare PECOS Information:
  • PECOS PAC ID: 3678673399
  • Enrollment ID: I20070711000128

Medical Identifiers

Medical identifiers for Shade Raymond Preston Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053431635NPI-NPPES
G58811MedicaidSC
P00424799OtherGARAILROAD MEDICARE
159750664AMedicaidGA

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207L00000XAnesthesiology 058811 (Georgia)Primary
207LP2900XAnesthesiology - Pain Medicine 058811 (Georgia)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
University HospitalAugusta, GAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Piedmont Anesthesia Llc2163837972155

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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. Shade Raymond Preston Iv allows following entities to bill medicare on his behalf.
Entity NameUniversity Anesthesiology Assoc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790722593
PECOS PAC ID: 4789586314
Enrollment ID: O20040123000807

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Entity NamePiedmont Anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1700474244
PECOS PAC ID: 2163837972
Enrollment ID: O20210208002823

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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. Shade Raymond Preston Iv 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 AddressPractice Location Address
Shade Raymond Preston Iv, DO
1824 Walton Way,
Augusta, GA 30904-3804

Ph: (706) 737-9250
Shade Raymond Preston Iv, DO
1350 Walton Way,
Augusta, GA 30901-2612

Ph: (706) 737-9250

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Anesthesiology Doctors in Augusta, GA

Rosa Maria Lopez Rincon,
Anesthesiology
Medicare: Not Enrolled in Medicare
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-446-5836    
Yulia Kungurova, MD
Anesthesiology
Medicare: Medicare Enrolled
Practice Location: 1120 15th St # Bi-2183, Augusta, GA 30912
Phone: 706-721-0180    
Richard E. Lynch, MD
Anesthesiology
Medicare: Accepting Medicare Assignments
Practice Location: 804 Scott Nixon Memorial Dr, Attn: Provider Enrollment, Augusta, GA 30907
Phone: 800-394-4445    Fax: 706-955-0735
Dr. Edward Kurt Leahy,
Anesthesiology
Medicare: Not Enrolled in Medicare
Practice Location: 1 Freedom Way, Augusta, GA 30904
Phone: 706-733-0188    
Dr. Marshall D. Bedder, M.D.
Anesthesiology
Medicare: Medicare Enrolled
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-3813    
Dr. John William Whiteley, MD
Anesthesiology
Medicare: Medicare Enrolled
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-3873    Fax: 706-721-7763
Sami Mohammad Hafsa, MD
Anesthesiology
Medicare: Medicare Enrolled
Practice Location: 1120 15th St, Augusta, GA 30912
Phone: 706-721-3871    

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