Dr Demetrious J Blackmon, MD - Medicare Nephrology in Stockbridge, GA

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Dr Demetrious J Blackmon, MD is a medicare enrolled "Internal Medicine - Nephrology" physician in Stockbridge, Georgia. He went to University Of South Alabama College Of Medicine and graduated in 2002 and has 22 years of diverse experience with area of expertise as Nephrology. He is a member of the group practice Preferred Vascular Services Southwest, Preferred Vascular Services Northwest Llc, Preferred Vascular Services Southeast Llc, Preferred Vascular Services Macon Llc and his current practice location is 250 Village Center Pwky, Suite 100, Stockbridge, Georgia. You can reach out to his office (for appointments etc.) via phone at (678) 289-0508.

Dr Demetrious J Blackmon is licensed to practice in Georgia (license number 57778) 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 1578592994.

Contact Information

Dr Demetrious J Blackmon, MD
250 Village Center Pwky, Suite 100,
Stockbridge, GA 30281-9044
(678) 289-0508
(678) 289-0124

Map and Direction




Physician's Profile

Full NameDr Demetrious J Blackmon
GenderMale
SpecialityNephrology
Experience22 Years
Location250 Village Center Pwky, Stockbridge, Georgia
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Demetrious J Blackmon attended and graduated from University Of South Alabama College Of Medicine in 2002
  NPI Data:
  • NPI Number: 1578592994
  • Provider Enumeration Date: 06/30/2006
  • Last Update Date: 03/04/2015
  Medicare PECOS Information:
  • PECOS PAC ID: 6103851225
  • Enrollment ID: I20080520000248

Medical Identifiers

Medical identifiers for Dr Demetrious J Blackmon such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1578592994NPI-NPPES
009934159MedicaidAL
662769049AMedicaidGA
P00254515OtherTNRAILROAD MEDICARE
3334458MedicaidTN
4111806OtherTNBCBS OF TENNESSEE
662769049FMedicaidGA
3334459MedicaidTN
581365705OtherGACHAMPUS
4152444OtherTNBLUE CROSS

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine MD38696 (Tennessee)Secondary
207RN0300XInternal Medicine - Nephrology 57778 (Georgia)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Preferred Vascular Services Southwest04465029188
Preferred Vascular Services Northwest Llc185055214211
Preferred Vascular Services Southeast Llc357781231214
Preferred Vascular Services Macon Llc64061089842

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. Dr Demetrious J Blackmon allows following entities to bill medicare on his behalf.
Entity NameSouthern Crescent Nephrology Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1659328474
PECOS PAC ID: 2466449269
Enrollment ID: O20040426000955
Entity NamePreferred Vascular Services Northwest Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1598037822
PECOS PAC ID: 1850552142
Enrollment ID: O20120413000013
Entity NamePreferred Vascular Services Southeast Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1861992976
PECOS PAC ID: 3577812312
Enrollment ID: O20180828000280
Entity NamePreferred Vascular Services Southwest
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1790285229
PECOS PAC ID: 0446502918
Enrollment ID: O20181010003246
Entity NamePreferred Vascular Services Macon Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1437659455
PECOS PAC ID: 6406108984
Enrollment ID: O20181010003906
Entity NamePreferred Vascular Services Northeast
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1780184218
PECOS PAC ID: 3577815695
Enrollment ID: O20181017002434
Entity NameMonogram Health Professional Services Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255930228
PECOS PAC ID: 4880004183
Enrollment ID: O20210505003249

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. Dr Demetrious J Blackmon 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 AddressPractice Location Address
Dr Demetrious J Blackmon, MD
250 Village Center Pkwy, Suite 100,
Stockbridge, GA 30281-9104

Ph: (678) 289-0508		Dr Demetrious J Blackmon, MD
250 Village Center Pwky, Suite 100,
Stockbridge, GA 30281-9044

Ph: (678) 289-0508

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.