Mark W Bookout, MD is a medicare enrolled "Otolaryngology" physician in East Ridge, Tennessee. His current practice location is
4151 Ringgold Rd, East Ridge, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(423) 622-5165.
Mark W Bookout is licensed to practice in Tennessee (license number 011511) 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 1356339063.
Physician's Profile
| Full Name | Mark W Bookout |
|---|
| Gender | Male |
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| Speciality | Otolaryngology |
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| Location | 4151 Ringgold Rd, East Ridge, Tennessee |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1356339063
- Provider Enumeration Date: 10/07/2005
- Last Update Date: 12/10/2012
Medicare PECOS Information:
- PECOS PAC ID: 8921141128
- Enrollment ID: I20100211000002
Medical Identifiers
Medical identifiers for Mark W Bookout such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356339063 | NPI | - | NPPES |
| 000282125B | Medicaid | GA | |
| 3021453 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Y00000X | Otolaryngology | 011511 (Tennessee) | Primary |
| 207Y00000X | Otolaryngology | 025947 (Georgia) | Secondary |
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. Mark W Bookout allows following entities to bill medicare on his behalf.
| Entity Name | Comprehensive Medical Care, P.c. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1316915986
PECOS PAC ID: 9931181781
Enrollment ID: O20040604000274 |
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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. Mark W Bookout 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 |
|---|
Mark W Bookout, MD
6918 Shallowford Rd, Suite 206,
Chattanooga, TN 37421-6784
Ph: (423) 855-2552 | Mark W Bookout, MD
4151 Ringgold Rd,
East Ridge, TN 37412-2434
Ph: (423) 622-5165 |
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