Derek Paul Pendarvis, MD in Gainesville, GA

Derek Paul Pendarvis, MD is a medicare enrolled "Surgery" physician in Gainesville, Georgia. He went to Medical University Of South Carolina College Of Medicine and graduated in 1996 and has 28 years of diverse experience with area of expertise as General Surgery. He is a member of the group practice The Longstreet Clinic, Pc and his current practice location is 725 Jesse Jewell Pkwy Se, Gainesville, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 536-2323.

Derek Paul Pendarvis is licensed to practice in Georgia (license number 049933) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1104806108.

Contact Information

	Derek Paul Pendarvis, MD
	725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834
	(770) 536-2323
	(770) 536-4947

Map and Direction

Physician's Profile

Full Name	Derek Paul Pendarvis
Gender	Male
Speciality	General Surgery
Experience	28 Years
Location	725 Jesse Jewell Pkwy Se, Gainesville, Georgia
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Derek Paul Pendarvis attended and graduated from Medical University Of South Carolina College Of Medicine in 1996

NPI Data:

NPI Number: 1104806108
Provider Enumeration Date: 01/18/2006
Last Update Date: 05/22/2024

Medicare PECOS Information:

PECOS PAC ID: 2466578935
Enrollment ID: I20100922000642

Medical Identifiers

Medical identifiers for Derek Paul Pendarvis such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1104806108	NPI	-	NPPES
1700231	Other	GA	UNITED HEALTHCARE
000904274A	Medicaid	GA
10045029	Other	GA	AMERIGROUP
52843776	Other	GA	BCBS
000904274B	Medicaid	GA
341106	Other	GA	WELLCARE
7816063	Other	GA	CIGNA
20050660	Other	GA	RR MEDICARE-GRP # CC4177

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208600000X	Surgery	049933 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Northeast Georgia Medical Center, Inc	Gainesville, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
The Longstreet Clinic, Pc	2668465733	145

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. Derek Paul Pendarvis allows following entities to bill medicare on his behalf.

Entity Name	The Longstreet Clinic, Pc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326019977 PECOS PAC ID: 2668465733 Enrollment ID: O20040405001521

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. Derek Paul Pendarvis 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
Derek Paul Pendarvis, MD Po Box 658, Gainesville, GA 30503-0658 Ph: (770) 718-1122	Derek Paul Pendarvis, MD 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501-3834 Ph: (770) 536-2323

Reviews and Comments

Surgery Doctors in Gainesville, GA

Dr. Thomas Gregory Delong, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 1387 Springdale Rd, Gainesville, GA 30501 Phone: 770-534-0984
Courtney L Grant, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501 Phone: 678-207-4000 Fax: 770-531-2435
Phillip Patrick Rideout, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 200 S Enota Dr Ne Ste 360, Gainesville, GA 30501 Phone: 770-219-4000
Alexis Deana Smith, MD Surgery Medicare: Medicare Enrolled Practice Location: 1439 Jesse Jewell Pkwy Ne Ste 301, Gainesville, GA 30501 Phone: 770-219-9234
Julius Timothy Fulenwider, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 1075 Jesse Jewell Pkwy Ne, Ste B, Gainesville, GA 30501 Phone: 770-536-5733 Fax: 770-534-2114
James A. Butts Jr., MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 725 Jesse Jewell Pkwy Se, Gainesville, GA 30501 Phone: 770-536-2323 Fax: 770-536-4947

Derek Paul Pendarvis, MD - Medicare General Surgery in Gainesville, GA