Dr Ellis Ifeanyichukwu Efobi, MD is a medicare enrolled "General Practice" physician in Stone Mountain, Georgia. His current practice location is
1525 E. Park Place Blvd., Suite 300, Stone Mountain, Georgia. You can reach out to his office (for appointments etc.) via phone at
(770) 879-7707.
Dr Ellis Ifeanyichukwu Efobi is licensed to practice in Georgia (license number 060727) 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 1144487018.
Physician's Profile
| Full Name | Dr Ellis Ifeanyichukwu Efobi |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 1525 E. Park Place Blvd., Stone Mountain, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1144487018
- Provider Enumeration Date: 05/19/2008
- Last Update Date: 02/02/2011
Medicare PECOS Information:
- PECOS PAC ID: 8426185984
- Enrollment ID: I20100415000312
Medical Identifiers
Medical identifiers for Dr Ellis Ifeanyichukwu Efobi such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1144487018 | NPI | - | NPPES |
| 594981959A | Medicaid | GA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | 060727 (Georgia) | Primary |
| 2081P2900X | Physical Medicine & Rehabilitation - Pain Medicine | 060727 (Georgia) | Secondary |
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 Ellis Ifeanyichukwu Efobi allows following entities to bill medicare on his behalf.
| Entity Name | Careperks Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1992323398
PECOS PAC ID: 9335551506
Enrollment ID: O20240314002701 |
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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 Ellis Ifeanyichukwu Efobi 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 |
|---|
Dr Ellis Ifeanyichukwu Efobi, MD
1525 E. Park Place Blvd., Suite 300,
Stone Mountain, GA 30087-3453
Ph: (770) 879-7707 | Dr Ellis Ifeanyichukwu Efobi, MD
1525 E. Park Place Blvd., Suite 300,
Stone Mountain, GA 30087-3453
Ph: (770) 879-7707 |
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