Patricia Jo Van Brunt, PA is a medicare enrolled "Physician Assistant" in Pembroke, Georgia. Her current practice location is
159 W. Railroad Street, Pembroke, Georgia. You can reach out to her office (for appointments etc.) via phone at
(912) 653-2897.
Patricia Jo Van Brunt is licensed to practice in Georgia (license number 6037) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1235103326.
Provider's Profile
| Full Name | Patricia Jo Van Brunt |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Location | 159 W. Railroad Street, Pembroke, Georgia |
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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: 1235103326
- Provider Enumeration Date: 02/15/2006
- Last Update Date: 03/31/2023
Medicare PECOS Information:
- PECOS PAC ID: 5496947012
- Enrollment ID: I20241227002364
Medical Identifiers
Medical identifiers for Patricia Jo Van Brunt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1235103326 | NPI | - | NPPES |
| 006037 | Other | GA | GEORGIA MEDICAL BOARD |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363AM0700X | Physician Assistant - Medical | MP00663 (New Jersey) | Secondary |
| 363A00000X | Physician Assistant | 6037 (Georgia) | Primary |
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. Patricia Jo Van Brunt 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 |
|---|
Patricia Jo Van Brunt, PA
602 E. 72nd Street,
Savannah, GA 31405-4913
Ph: (912) 819-7878 | Patricia Jo Van Brunt, PA
159 W. Railroad Street,
Pembroke, GA 31321-0190
Ph: (912) 653-2897 |
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