Dontre' M Douse, MD is a medicare enrolled "Otolaryngology - Plastic Surgery Within The Head & Neck" physician in Tifton, Georgia. His current practice location is
39 Kent Rd Ste 2, Tifton, Georgia. You can reach out to his office (for appointments etc.) via phone at
(229) 353-4368.
Dontre' M Douse is licensed to practice in Georgia (license number 104748) 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 1396372694.
Physician's Profile
| Full Name | Dontre' M Douse |
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| Gender | Male |
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| Speciality | Otolaryngology - Plastic Surgery Within The Head & Neck |
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| Location | 39 Kent Rd Ste 2, Tifton, 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: 1396372694
- Provider Enumeration Date: 03/25/2020
- Last Update Date: 07/03/2025
Medicare PECOS Information:
- PECOS PAC ID: 4880018274
- Enrollment ID: I20210904000008
Medical Identifiers
Medical identifiers for Dontre' M Douse such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1396372694 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 69872 (Minnesota) | Secondary |
| 207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 30873 (Minnesota) | Secondary |
| 207YX0007X | Otolaryngology - Plastic Surgery Within The Head & Neck | 104748 (Georgia) | 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. Dontre' M Douse allows following entities to bill medicare on his behalf.
| Entity Name | Mayo Clinic |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1922074434
PECOS PAC ID: 6507778255
Enrollment ID: O20031103000285 |
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| Entity Name | Mayo Clinic Health System-southeast Minnesota Region |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1891701637
PECOS PAC ID: 4385556703
Enrollment ID: O20031104000408 |
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| Entity Name | Mayo Clinic Health System-southwest Minnesota Region |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1578545422
PECOS PAC ID: 4688585771
Enrollment ID: O20031110000134 |
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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. Dontre' M Douse 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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Dontre' M Douse, MD
Po Box 2650,
Tifton, GA 31793-2650
Ph: () - | Dontre' M Douse, MD
39 Kent Rd Ste 2,
Tifton, GA 31794-1697
Ph: (229) 353-4368 |
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