Gregory Avetisov, DO in Lakeport, CA - Medicare General Practice

Gregory Avetisov, DO is a medicare enrolled "Internal Medicine" physician in Lakeport, California. He went to New York College Of Osteo Medicine Of New York Institute Of Technology and graduated in 2017 and has 8 years of diverse experience with area of expertise as General Practice. He is a member of the group practice Lake County Tribal Health Consortium Inc and his current practice location is 925 Bevins Court, Lakeport, California. You can reach out to his office (for appointments etc.) via phone at (707) 263-8383.

Gregory Avetisov is licensed to practice in California (license number 20A22510) and he also participates in the medicare program. He may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1679917280.

Contact Information

	Gregory Avetisov, DO
	925 Bevins Court, Lakeport, CA 95453-9754
	(707) 263-8383
	(707) 263-5019

Map and Direction

Physician's Profile

Full Name	Gregory Avetisov
Gender	Male
Speciality	General Practice
Experience	8 Years
Location	925 Bevins Court, Lakeport, California
Accepts Medicare Assignments	May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.

Medical Education and Training:

Gregory Avetisov attended and graduated from New York College Of Osteo Medicine Of New York Institute Of Technology in 2017

NPI Data:

NPI Number: 1679917280
Provider Enumeration Date: 04/25/2013
Last Update Date: 01/06/2025

Medicare PECOS Information:

PECOS PAC ID: 9335470400
Enrollment ID: I20240716004349

Medical Identifiers

Medical identifiers for Gregory Avetisov such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1679917280	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208D00000X	General Practice	OS17139 (Florida)	Secondary
207R00000X	Internal Medicine	20A22510 (California)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Sutter Lakeside Hospital	Lakeport, CA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Lake County Tribal Health Consortium Inc	8729975545	37

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. Gregory Avetisov allows following entities to bill medicare on his behalf.

Entity Name	Lake County Tribal Health Consortium Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1881697381 PECOS PAC ID: 8729975545 Enrollment ID: O20040304000323

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. Gregory Avetisov 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
Gregory Avetisov, DO Po Box 1950, Lakeport, CA 95453-1950 Ph: (707) 263-8383	Gregory Avetisov, DO 925 Bevins Court, Lakeport, CA 95453-9754 Ph: (707) 263-8383

Reviews and Comments

Internal Medicine Doctors in Lakeport, CA

Bradley Trent Clair, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 5196 Hill Rd E, Ste 202, Lakeport, CA 95453 Phone: 707-263-1777 Fax: 707-263-8137
Dr. Charles Joseph Seage, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 5335 Lakeshore Blvd, Lakeport, CA 95453 Phone: 707-472-4596 Fax: 707-462-7078
Dr. Diane Joan Pege, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-5117 Fax: 707-262-5094
Anne E Tait, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 5150 Hill Rd E Ste C, Lakeport, CA 95453 Phone: 707-263-3520 Fax: 707-263-3570
Dr. John Mathew Schweifler, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 5150 Hill Rd E Ste B, Lakeport, CA 95453 Phone: 707-263-7082
Dr. Fareed Ramzi Asfour, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 628-600-3589
Dr. Elyse Midori Donald, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 5150 Hill Rd E Ste B, Lakeport, CA 95453 Phone: 707-263-7082

Gregory Avetisov, DO - Medicare General Practice in Lakeport, CA