Mr Jed Dean Zak, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Picayune, Mississippi. His current practice location is
801 Goodyear Blvd, Picayune, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(601) 798-4711.
Mr Jed Dean Zak is licensed to practice in Mississippi (license number R867178) 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 1053447037.
Provider's Profile
| Full Name | Mr Jed Dean Zak |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 801 Goodyear Blvd, Picayune, Mississippi |
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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: 1053447037
- Provider Enumeration Date: 02/26/2007
- Last Update Date: 01/15/2019
Medicare PECOS Information:
- PECOS PAC ID: 8921087941
- Enrollment ID: I20040714001094
Medical Identifiers
Medical identifiers for Mr Jed Dean Zak such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1053447037 | NPI | - | NPPES |
| 336508YYGZ | Other | MS | MEDICARE |
| 01689315 | Medicaid | MS | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 367500000X | Nurse Anesthetist, Certified Registered | R867178 (Mississippi) | 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. Mr Jed Dean Zak allows following entities to bill medicare on his behalf.
| Entity Name | Forrest County General Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1295837631
PECOS PAC ID: 1052397767
Enrollment ID: O20040624001351 |
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| Entity Name | Deep South Anesthesia, Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164738712
PECOS PAC ID: 4284897612
Enrollment ID: O20120523000317 |
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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. Mr Jed Dean Zak 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 |
|---|
Mr Jed Dean Zak, CRNA
26 N Hill Dr W,
Carriere, MS 39426-8147
Ph: (601) 749-5976 | Mr Jed Dean Zak, CRNA
801 Goodyear Blvd,
Picayune, MS 39466-3221
Ph: (601) 798-4711 |
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