Dr Bret Bouton Wagenhorst, MD is a medicare enrolled "Ophthalmology" physician in Tifton, Georgia. He went to Stanford University School Of Medicine and graduated in 1989 and has 36 years of diverse experience with area of expertise as Ophthalmology. He is a member of the group practice Tift Regional Health System Inc and his current practice location is
1803 Old Ocilla Rd, Tifton, Georgia. You can reach out to his office (for appointments etc.) via phone at
(229) 386-2181.
Dr Bret Bouton Wagenhorst is licensed to practice in Georgia (license number 044138) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1841201134.
Physician's Profile
| Full Name | Dr Bret Bouton Wagenhorst |
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| Gender | Male |
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| Speciality | Ophthalmology |
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| Experience | 36 Years |
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| Location | 1803 Old Ocilla Rd, Tifton, Georgia |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Bret Bouton Wagenhorst attended and graduated from Stanford University School Of Medicine in 1989
NPI Data:
- NPI Number: 1841201134
- Provider Enumeration Date: 08/11/2006
- Last Update Date: 03/08/2021
Medicare PECOS Information:
- PECOS PAC ID: 1850567231
- Enrollment ID: I20120106000155
Medical Identifiers
Medical identifiers for Dr Bret Bouton Wagenhorst such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1841201134 | NPI | - | NPPES |
| 077471001 | Other | GA | CIGNA |
| 00760856A | Medicaid | GA | |
| 180041335 | Other | GA | RRMC |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207W00000X | Ophthalmology | 044138 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Tift Regional Health System Inc | 2062745169 | 262 |
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 Bret Bouton Wagenhorst allows following entities to bill medicare on his behalf.
| Entity Name | Tift Regional Health System, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1790280857
PECOS PAC ID: 5193619971
Enrollment ID: O20040212000064 |
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| Entity Name | Tift Regional Health System Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1881203305
PECOS PAC ID: 2062745169
Enrollment ID: O20200217002409 |
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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 Bret Bouton Wagenhorst 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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Dr Bret Bouton Wagenhorst, MD
907 18th St E Ste 400,
Tifton, GA 31794-3684
Ph: (229) 353-3450 | Dr Bret Bouton Wagenhorst, MD
1803 Old Ocilla Rd,
Tifton, GA 31794-1617
Ph: (229) 386-2181 |
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