Mr Anthony E Medina, is a medicare enrolled "Physician Assistant - Medical" provider in Suwanee, Georgia. His current practice location is
2696 Lawrenceville Suwanee Rd, Suwanee, Georgia. You can reach out to his office (for appointments etc.) via phone at
(678) 376-1300.
Mr Anthony E Medina is licensed to practice in Georgia (license number 006030) 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 1174779177.
Healthcare Provider's Profile
Full Name | Mr Anthony E Medina |
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Gender | Male |
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Speciality | Physician Assistant - Medical |
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Location | 2696 Lawrenceville Suwanee Rd, Suwanee, Georgia |
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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: 1174779177
- Provider Enumeration Date: 08/11/2008
- Last Update Date: 05/18/2011
Medicare PECOS Information:
- PECOS PAC ID: 8921259904
- Enrollment ID: I20121126000154
Medical Identifiers
Medical identifiers for Mr Anthony E Medina such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1174779177 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | RC60035704 (Washington) | Secondary |
363AM0700X | Physician Assistant - Medical | 006030 (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. Mr Anthony E Medina 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 Anthony E Medina, 2696 Lawrenceville Suwanee Rd, Suwanee, GA 30024-2535 Ph: (678) 376-1300 | Mr Anthony E Medina, 2696 Lawrenceville Suwanee Rd, Suwanee, GA 30024-2535 Ph: (678) 376-1300 |
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