Garrett Kungho Ni, MD is a medicare enrolled "Otolaryngology - Otolaryngology/facial Plastic Surgery" physician in Mount Carmel, Illinois. His current practice location is 
1418 College Dr, Mount Carmel, Illinois. You can reach out to his office (for appointments etc.) via phone at 
(618) 262-2278.
Garrett Kungho Ni is licensed to practice in California (license number A196402) 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 1477113116.
			
			
			
			
			
		 
		
		 
Physician's Profile
		
			
			
			| Full Name | Garrett Kungho Ni | 
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| Gender | Male | 
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| Speciality | Otolaryngology - Otolaryngology/facial Plastic Surgery | 
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| Location | 1418 College Dr, Mount Carmel, Illinois | 
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
			
			 
			
						  NPI Data:
			
			- NPI Number: 1477113116
 - Provider Enumeration Date: 06/14/2019
 - Last Update Date: 09/24/2025
 			
			  Medicare PECOS Information:
- PECOS PAC ID: 1355676412
 - Enrollment ID: I20240604004334
 
			 
		 
		 
Medical Identifiers
		Medical identifiers for Garrett Kungho Ni such as npi, medicare ID, medicare PIN, medicaid, etc.
		
		| Identifier | Type | State | Issuer | 
		| 1477113116 | NPI | - | NPPES | 
		
		 
Medical Taxonomies and Licenses
		
		| Taxonomy | Type | License (State) | Status | 
		| 207Y00000X | Otolaryngology  | MT217956 (Pennsylvania) | Secondary | 
| 207YX0905X | Otolaryngology - Otolaryngology/facial Plastic Surgery  | A196402 (California) | 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. Garrett Kungho Ni allows following entities to bill medicare on his behalf.
| Entity Name | The Regents Of The University Of California | 
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| Entity Type | Part B Supplier - Clinic/group Practice | 
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| Entity Identifiers | NPI Number: 1619935251 PECOS PAC ID: 6406749308 Enrollment ID: O20040204000971 | 
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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. Garrett Kungho Ni 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 | 
		Garrett Kungho Ni, MD 1418 College Dr, Mount Carmel, IL 62863-2638 Ph: (618) 262-2278 | Garrett Kungho Ni, MD 1418 College Dr, Mount Carmel, IL 62863-2638 Ph: (618) 262-2278 | 
		
		 
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