Dr Avanelle V Jack, MD in Brunswick, GA - Medicare Internal Medicine

Dr Avanelle V Jack, MD is a medicare enrolled "Internal Medicine - Nephrology" physician in Brunswick, Georgia. Her current practice location is 208 Scranton Connector Ste 117, Brunswick, Georgia. You can reach out to her office (for appointments etc.) via phone at (912) 264-5961.

Dr Avanelle V Jack is licensed to practice in Georgia (license number 78666) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1316996671.

Contact Information

	Dr Avanelle V Jack, MD
	208 Scranton Connector Ste 117, Brunswick, GA 31525-0560
	(912) 264-5961
	(912) 262-9499

Map and Direction

Physician's Profile

Full Name	Dr Avanelle V Jack
Gender	Female
Speciality	Internal Medicine - Nephrology
Location	208 Scranton Connector Ste 117, Brunswick, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1316996671
Provider Enumeration Date: 05/06/2006
Last Update Date: 10/24/2017

Medicare PECOS Information:

PECOS PAC ID: 7012933344
Enrollment ID: I20051017000537

Medical Identifiers

Medical identifiers for Dr Avanelle V Jack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1316996671	NPI	-	NPPES
1491501	Medicaid	LA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RN0300X	Internal Medicine - Nephrology	MD.022645 (Louisiana)	Secondary
207RN0300X	Internal Medicine - Nephrology	78666 (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 Avanelle V Jack allows following entities to bill medicare on her behalf.

Entity Name	Louisiana State University School Of Medicine In New Orleans Faculty G
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477582526 PECOS PAC ID: 0244136448 Enrollment ID: O20031209000661

Entity Name	Main Street Physician Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1396150785 PECOS PAC ID: 8022331909 Enrollment ID: O20141229001749

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 Avanelle V Jack 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 Avanelle V Jack, MD 208 Scranton Connector, Suite 117, Brunswick, GA 31525 Ph: (912) 264-5961	Dr Avanelle V Jack, MD 208 Scranton Connector Ste 117, Brunswick, GA 31525-0560 Ph: (912) 264-5961

Reviews and Comments

Internal Medicine Doctors in Brunswick, GA

Avery Wade Strickland, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 2500 Starling St, Suite #404, Brunswick, GA 31520 Phone: 912-264-1520 Fax: 912-264-1526
Ms. Stephanie Irene Spencer, APRN Nephrology Medicare: May Accept Medicare Assignments Practice Location: 2415 Parkwood Dr, Brunswick, GA 31520 Phone: 912-466-7681 Fax: 912-264-2788
Christopher Kolasa, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 3025 Shrine Rd Ste 450, Brunswick, GA 31520 Phone: 912-264-6133 Fax: 912-267-1415
William George Grubb, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 3025 Shrine Rd, Suite 450, Brunswick, GA 31520 Phone: 912-264-6133 Fax: 912-267-1415
Viagnehy Fernandez, M.D. Nephrology Medicare: Accepting Medicare Assignments Practice Location: 2415 Parkwood Dr, Brunswick, GA 31520 Phone: 912-466-7188 Fax: 912-466-7185
Jordan Ahnert, APRN Nephrology Medicare: Medicare Enrolled Practice Location: 3226 Hampton Ave Ste A, Brunswick, GA 31520 Phone: 912-264-0760
Mrs. Margaret Stoakes Tuten, FNPC, CDE Nephrology Medicare: Not Enrolled in Medicare Practice Location: 2500 Starling St, Suite 605, Brunswick, GA 31520 Phone: 912-466-5601 Fax: 912-466-5613

Dr Avanelle V Jack, MD - Medicare Internal Medicine in Brunswick, GA