Edwige Goby Konwo-tayo, is a medicare enrolled "Nurse Practitioner - Family" physician in Stone Mountain, Georgia. She graduated from medical school in 2017 and has 8 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Wellstreet Of Georgia Pc and her current practice location is
1183 S Hairston Rd Ste A, Stone Mountain, Georgia. You can reach out to her office (for appointments etc.) via phone at
(404) 296-8858.
Edwige Goby Konwo-tayo is licensed to practice in Georgia (license number RN220667) 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 1538646526.
Physician's Profile
| Full Name | Edwige Goby Konwo-tayo |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 8 Years |
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| Location | 1183 S Hairston Rd Ste A, Stone Mountain, Georgia |
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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:
- Edwige Goby Konwo-tayo graduated from medical school in 2017
NPI Data:
- NPI Number: 1538646526
- Provider Enumeration Date: 07/23/2018
- Last Update Date: 12/30/2019
Medicare PECOS Information:
- PECOS PAC ID: 9335576032
- Enrollment ID: I20200218002729
Medical Identifiers
Medical identifiers for Edwige Goby Konwo-tayo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1538646526 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | RN220667 (Georgia) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN220667 (Georgia) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Wellstreet Of Georgia Pc | 7517126279 | 440 |
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. Edwige Goby Konwo-tayo allows following entities to bill medicare on her behalf.
| Entity Name | Wellstreet Of Georgia Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235411547
PECOS PAC ID: 7517126279
Enrollment ID: O20120315000603 |
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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. Edwige Goby Konwo-tayo 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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Edwige Goby Konwo-tayo,
814 Lazarus Dr,
Woodstock, GA 30188-5100
Ph: (404) 825-6874 | Edwige Goby Konwo-tayo,
1183 S Hairston Rd Ste A,
Stone Mountain, GA 30088-2796
Ph: (404) 296-8858 |
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