Goran Djordje Antic, MD is a medicare enrolled "Emergency Medicine" physician in Pulaski, Tennessee. His current practice location is
1265 E College St, Pulaski, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(931) 363-7531.
Goran Djordje Antic is licensed to practice in Tennessee (license number 34506) 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 1124074752.
Physician's Profile
| Full Name | Goran Djordje Antic |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 1265 E College St, Pulaski, Tennessee |
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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: 1124074752
- Provider Enumeration Date: 05/25/2006
- Last Update Date: 11/06/2007
Medicare PECOS Information:
- PECOS PAC ID: 7618878414
- Enrollment ID: I20040115000539
Medical Identifiers
Medical identifiers for Goran Djordje Antic such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1124074752 | NPI | - | NPPES |
| P00372629 | Other | TN | RAILROAD MEDICARE |
| 3859664 | Medicaid | TN | |
| 4072313 | Other | TN | BCBSTN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 34506 (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. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Goran Djordje Antic allows following entities to bill medicare on his behalf.
| Entity Name | Emergency Coverage Corp |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1427005008
PECOS PAC ID: 3072412592
Enrollment ID: O20050207000666 |
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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. Goran Djordje Antic 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 |
|---|
Goran Djordje Antic, MD
Po Box 636019,
Cincinnati, OH 45263-6019
Ph: () - | Goran Djordje Antic, MD
1265 E College St,
Pulaski, TN 38478-4541
Ph: (931) 363-7531 |
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