Ebot B Manga, in Dacula, GA - Medicare Nurse Practitioner

Ebot B Manga, is a medicare enrolled "Nurse Practitioner - Family" in Dacula, Georgia. His current practice location is 2064 Lilac Arbor Way, Dacula, Georgia. You can reach out to his office (for appointments etc.) via phone at (678) 887-4367.

Ebot B Manga is licensed to practice in Georgia (license number 147685) 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 1164920716.

Contact Information

	Ebot B Manga,
	2064 Lilac Arbor Way, Dacula, GA 30019-2475
	(678) 887-4367
	Not Available

Map and Direction

Provider's Profile

Full Name	Ebot B Manga
Gender	Male
Speciality	Nurse Practitioner - Family
Location	2064 Lilac Arbor Way, Dacula, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1164920716
Provider Enumeration Date: 01/29/2018
Last Update Date: 07/20/2021

Medicare PECOS Information:

PECOS PAC ID: 7517313125
Enrollment ID: I20231101003382

Medical Identifiers

Medical identifiers for Ebot B Manga such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1164920716	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	147685 (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. Ebot B Manga allows following entities to bill medicare on his behalf.

Entity Name	Amazing Family & Healthcare Services Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1518666346 PECOS PAC ID: 9739615394 Enrollment ID: O20241206001118

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. Ebot B Manga 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
Ebot B Manga, 2064 Lilac Arbor Way, Dacula, GA 30019-2475 Ph: (678) 887-4367	Ebot B Manga, 2064 Lilac Arbor Way, Dacula, GA 30019-2475 Ph: (678) 887-4367

Reviews and Comments

Nurse Practitioner Nurses in Dacula, GA

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Ebot B Manga, - Medicare Nurse Practitioner in Dacula, GA