Regen Osteo is a medicare enrolled "Physician Assistant" provider in Dallas, Georgia. Their current practice location is
243 Merchants Drive, Dallas, Georgia. You can reach out to their office (for appointments etc.) via phone at
(770) 445-1362.
Regen Osteo is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Regen Osteo
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1609096213.
Healthcare Provider's Profile
| Full Name | Regen Osteo |
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| Type | Facility |
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| Speciality | Physician Assistant |
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| Location | 243 Merchants Drive, Dallas, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1609096213
- Provider Enumeration Date: 04/26/2007
- Last Update Date: 05/24/2022
Medicare PECOS Information:
- PECOS PAC ID: 9032161864
- Enrollment ID: O20050221000074
Medical Identifiers
Medical identifiers for Regen Osteo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1609096213 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | CHIR005181 (Georgia) | Secondary |
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works.
Regen Osteo acts as a billing entity for following providers:
| Provider Name | Jeff L Selano |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1780708461
PECOS PAC ID: 6204888035
Enrollment ID: I20111213000231 |
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| Provider Name | Steve Odeh |
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| Provider Type | Practitioner - General Practice |
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| Provider Identifiers | NPI Number: 1801940200
PECOS PAC ID: 8820078553
Enrollment ID: I20160425001794 |
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| Provider Name | Tammie Small Mccallie |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1265556948
PECOS PAC ID: 1456695410
Enrollment ID: I20181130002673 |
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| Provider Name | Catherine Wallace |
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| Provider Type | Practitioner - Urology |
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| Provider Identifiers | NPI Number: 1154946606
PECOS PAC ID: 1557786282
Enrollment ID: I20230228001205 |
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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. Regen Osteo 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 |
|---|
Regen Osteo
Po Box 419,
Dallas, GA 30132-0008
Ph: (770) 445-1362 | Regen Osteo
243 Merchants Drive,
Dallas, GA 30132
Ph: (770) 445-1362 |
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