Ricky Paul Gault, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Amory, Mississippi. His current practice location is
1105 Earl Frye Blvd, Amory, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 256-7111.
Ricky Paul Gault is licensed to practice in Mississippi (license number R619078) 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 1164441788.
Provider's Profile
| Full Name | Ricky Paul Gault |
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| Gender | Male |
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| Speciality | Nurse Anesthetist, Certified Registered |
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| Location | 1105 Earl Frye Blvd, Amory, Mississippi |
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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: 1164441788
- Provider Enumeration Date: 07/18/2006
- Last Update Date: 04/30/2014
Medicare PECOS Information:
- PECOS PAC ID: 2668420944
- Enrollment ID: I20050104000771
Medical Identifiers
Medical identifiers for Ricky Paul Gault such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1164441788 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 367500000X | Nurse Anesthetist, Certified Registered | R619078 (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. Ricky Paul Gault allows following entities to bill medicare on his behalf.
| Entity Name | Willow Anesthesia Services, Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1205169521 PECOS PAC ID: 9234279183 Enrollment ID: O20091228000308 |
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| Entity Name | Monroe Health Services Inc |
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| Entity Type | Part B Supplier - Hospital Department(s) |
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| Entity Identifiers | NPI Number: 1619559309 PECOS PAC ID: 8224376561 Enrollment ID: O20210602001080 |
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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. Ricky Paul Gault 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 |
Ricky Paul Gault, CRNA 123 Main St N, Amory, MS 38821-3416 Ph: (662) 256-7112 | Ricky Paul Gault, CRNA 1105 Earl Frye Blvd, Amory, MS 38821-5500 Ph: (662) 256-7111 |
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