Dr Crystal Lane Tate, MD is a medicare enrolled "Family Medicine" physician in Ecru, Mississippi. She went to University Of Mississippi School Of Medicine and graduated in 1992 and has 32 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Ms State Department Of Health and her current practice location is
375 Main St, Ecru, Mississippi. You can reach out to her office (for appointments etc.) via phone at
(662) 489-5609.
Dr Crystal Lane Tate is licensed to practice in Mississippi (license number 13565) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1255390472.
Physician's Profile
| Full Name | Dr Crystal Lane Tate |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 32 Years |
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| Location | 375 Main St, Ecru, Mississippi |
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| Accepts Medicare Assignments | Yes. She 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 Crystal Lane Tate attended and graduated from University Of Mississippi School Of Medicine in 1992
NPI Data:
- NPI Number: 1255390472
- Provider Enumeration Date: 03/17/2006
- Last Update Date: 12/04/2008
Medicare PECOS Information:
- PECOS PAC ID: 2567641277
- Enrollment ID: I20110127000447
Medical Identifiers
Medical identifiers for Dr Crystal Lane Tate such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1255390472 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 13565 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Ms State Department Of Health | 0244129245 | 4 |
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 Crystal Lane Tate allows following entities to bill medicare on her behalf.
| Entity Name | Ms State Department Of Health |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1053489260
PECOS PAC ID: 0244129245
Enrollment ID: O20040315000937 |
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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 Crystal Lane Tate 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 Crystal Lane Tate, MD
Po Box 492,
Ecru, MS 38841-0492
Ph: (662) 489-5609 | Dr Crystal Lane Tate, MD
375 Main St,
Ecru, MS 38841-9118
Ph: (662) 489-5609 |
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