Dr Mark Carroll Guerdan, DO is a medicare enrolled "Anesthesiology" in Riverdale, Georgia. His current practice location is
6525 Professional Pl, Suite B, Riverdale, Georgia. You can reach out to his office (for appointments etc.) via phone at
(404) 254-5496.
Dr Mark Carroll Guerdan is licensed to practice in Georgia (license number 61081) 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 1326089574.
Provider's Profile
| Full Name | Dr Mark Carroll Guerdan |
|---|
| Gender | Male |
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| Speciality | Anesthesiology |
|---|
| Location | 6525 Professional Pl, Riverdale, Georgia |
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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: 1326089574
- Provider Enumeration Date: 06/09/2006
- Last Update Date: 07/14/2014
Medicare PECOS Information:
- PECOS PAC ID: 2264336163
- Enrollment ID: I20090821000594
Medical Identifiers
Medical identifiers for Dr Mark Carroll Guerdan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1326089574 | NPI | - | NPPES |
| 003135346A | Medicaid | GA | |
| 003135345A | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 163W00000X | Registered Nurse | 31403 (Kentucky) | Secondary |
| 207L00000X | Anesthesiology | 62257 (New York) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 061081 (Georgia) | Secondary |
| 208VP0014X | Pain Medicine - Interventional Pain Medicine | 061081 (Georgia) | Secondary |
| 207L00000X | Anesthesiology | 61081 (Georgia) | Primary |
| 208VP0000X | Pain Medicine - Pain Medicine | 61081 (Georgia) | Secondary |
| 207LP2900X | Anesthesiology - Pain Medicine | 61081 (Georgia) | Secondary |
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 Mark Carroll Guerdan allows following entities to bill medicare on his behalf.
| Entity Name | Mip Medical Management |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1376813451
PECOS PAC ID: 2769646017
Enrollment ID: O20120618000200 |
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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. Dr Mark Carroll Guerdan 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 Mark Carroll Guerdan, DO
6525 Professional Pl, Suite B,
Riverdale, GA 30274-2519
Ph: (404) 254-5496 | Dr Mark Carroll Guerdan, DO
6525 Professional Pl, Suite B,
Riverdale, GA 30274-2519
Ph: (404) 254-5496 |
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