Jonathan Barak Fass, MD is a medicare enrolled "Dermatology" physician in Greensboro, Georgia. His current practice location is
1000 Cowles Clinic Way Ste 100, Greensboro, Georgia. You can reach out to his office (for appointments etc.) via phone at
(706) 543-5858.
Jonathan Barak Fass is licensed to practice in Georgia (license number 046089) 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 1104821917.
Physician's Profile
| Full Name | Jonathan Barak Fass |
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| Gender | Male |
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| Speciality | Dermatology |
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| Location | 1000 Cowles Clinic Way Ste 100, Greensboro, Georgia |
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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: 1104821917
- Provider Enumeration Date: 06/17/2005
- Last Update Date: 01/25/2024
Medicare PECOS Information:
- PECOS PAC ID: 6901921857
- Enrollment ID: I20101013000407
Medical Identifiers
Medical identifiers for Jonathan Barak Fass such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1104821917 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207N00000X | Dermatology | 046089 (Georgia) | 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. Jonathan Barak Fass allows following entities to bill medicare on his behalf.
| Entity Name | Dermatology Affiliates LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730244872 PECOS PAC ID: 5799763975 Enrollment ID: O20040713000970 |
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| Entity Name | Georgia Skin Cancer & Aestheitic Dermatology, LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205026168 PECOS PAC ID: 0244328649 Enrollment ID: O20071119000529 |
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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. Jonathan Barak Fass 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 |
Jonathan Barak Fass, MD 1180 Resurgence Dr Ste 100, Watkinsville, GA 30677-7211 Ph: (706) 543-5858 | Jonathan Barak Fass, MD 1000 Cowles Clinic Way Ste 100, Greensboro, GA 30642-5285 Ph: (706) 543-5858 |
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