Dr Donna Grimsley Mizelle, MD is a medicare enrolled "Family Medicine" physician in Pinewood, South Carolina. She went to Brody School Of Medicine At East Carolina University and graduated in 2000 and has 24 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Tandem Health Sc and her current practice location is
25 East Clark Street, Pinewood, South Carolina. You can reach out to her office (for appointments etc.) via phone at
(803) 774-4500.
Dr Donna Grimsley Mizelle is licensed to practice in South Carolina (license number 22449) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1760427678.
Physician's Profile
| Full Name | Dr Donna Grimsley Mizelle |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 24 Years |
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| Location | 25 East Clark Street, Pinewood, South Carolina |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Donna Grimsley Mizelle attended and graduated from Brody School Of Medicine At East Carolina University in 2000
NPI Data:
- NPI Number: 1760427678
- Provider Enumeration Date: 06/17/2006
- Last Update Date: 10/25/2022
Medicare PECOS Information:
- PECOS PAC ID: 0042116907
- Enrollment ID: I20080711000609
Medical Identifiers
Medical identifiers for Dr Donna Grimsley Mizelle such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760427678 | NPI | - | NPPES |
| 89135JN | Medicaid | NC | |
| L36646 | Medicaid | SC | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 200300669 (North Carolina) | Secondary |
| 207Q00000X | Family Medicine | 22449 (South Carolina) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Tandem Health Sc | 3870575855 | 27 |
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 Donna Grimsley Mizelle allows following entities to bill medicare on her behalf.
| Entity Name | Tandem Health Sc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1386630192
PECOS PAC ID: 3870575855
Enrollment ID: O20040603000514 |
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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. Dr Donna Grimsley Mizelle 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 |
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Dr Donna Grimsley Mizelle, MD
25 East Clark Street,
Pinewood, SC 29125
Ph: (803) 774-4500 | Dr Donna Grimsley Mizelle, MD
25 East Clark Street,
Pinewood, SC 29125
Ph: (803) 774-4500 |
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