Dr Alfred Walter Mazur, MD is a medicare enrolled "Urology" physician in Douglas, Georgia. His current practice location is
200 Doctors Dr, Suite 220, Douglas, Georgia. You can reach out to his office (for appointments etc.) via phone at
(912) 384-4030.
Dr Alfred Walter Mazur is licensed to practice in Georgia (license number 046695) 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 1255311619.
Physician's Profile
| Full Name | Dr Alfred Walter Mazur |
|---|
| Gender | Male |
|---|
| Speciality | Urology |
|---|
| Location | 200 Doctors Dr, Douglas, Georgia |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1255311619
- Provider Enumeration Date: 01/20/2006
- Last Update Date: 03/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 0042220451
- Enrollment ID: I20081119000426
Medical Identifiers
Medical identifiers for Dr Alfred Walter Mazur such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1255311619 | NPI | - | NPPES |
| 11D1105865 | Other | GA | CLIA ID - 17 JOHNSON ST |
| 046695 | Other | GA | PHYSICIAN LICENSE # |
| 477420 | Other | GA | WELLCARE |
| 000833412D | Medicaid | GA | |
| 000833412E | Medicaid | GA | |
| 11D1092458 | Other | GA | CLIA ID - 200 DOCTORS DR STE 220 |
| DH1281 | Other | GA | RAILROAD MEDICARE - GROUP # |
| P00726011 | Other | GA | RAILROAD MEDICARE - PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208800000X | Urology | 046695 (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. Dr Alfred Walter Mazur allows following entities to bill medicare on his behalf.
| Entity Name | Crh Physician Practices, Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1710046073
PECOS PAC ID: 5193727964
Enrollment ID: O20070207000243 |
|---|
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 Alfred Walter Mazur 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 Alfred Walter Mazur, MD
Po Box 1377,
Douglas, GA 31534-1377
Ph: (912) 384-1477 | Dr Alfred Walter Mazur, MD
200 Doctors Dr, Suite 220,
Douglas, GA 31533-2201
Ph: (912) 384-4030 |
Reviews and Comments