Dr Grady Ausbur Fortner, MD in Jacksonville, FL

Dr Grady Ausbur Fortner, MD is a medicare enrolled "Emergency Medicine" physician in Jacksonville, Florida. His current practice location is 554 Keily Street, Jacksonville, Florida. You can reach out to his office (for appointments etc.) via phone at (757) 953-7550.

Dr Grady Ausbur Fortner is licensed to practice in Guam (license number M-2191) 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 1043636202.

Contact Information

	Dr Grady Ausbur Fortner, MD
	554 Keily Street, Jacksonville, FL 32212
	(757) 953-7550
	(757) 953-7560

Map and Direction

Physician's Profile

Full Name	Dr Grady Ausbur Fortner
Gender	Male
Speciality	Emergency Medicine
Location	554 Keily Street, Jacksonville, Florida
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1043636202
Provider Enumeration Date: 03/12/2014
Last Update Date: 12/17/2019

Medicare PECOS Information:

PECOS PAC ID: 8123351574
Enrollment ID: I20200123000534

Medical Identifiers

Medical identifiers for Dr Grady Ausbur Fortner such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043636202	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207P00000X	Emergency Medicine	0116027243 (Virginia)	Secondary
207P00000X	Emergency Medicine	M-2191 (Guam)	Primary

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 Grady Ausbur Fortner allows following entities to bill medicare on his behalf.

Entity Name	Guam Healthcare Development Incorporated
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326447939 PECOS PAC ID: 9234351776 Enrollment ID: O20150326000266

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 Grady Ausbur Fortner 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 Grady Ausbur Fortner, MD Po Box 25578, Barrigada, GU 96921-5578 Ph: (671) 480-7934	Dr Grady Ausbur Fortner, MD 554 Keily Street, Jacksonville, FL 32212 Ph: (757) 953-7550

Reviews and Comments

Emergency Medicine Doctors in Jacksonville, FL

Andrew Lim, M.D. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 1504 Dunsford Rd, Jacksonville, FL 32207 Phone: 904-253-3734
Jennifer L. Mauzy, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4201 Belfort Rd, Jacksonville, FL 32216 Phone: 904-296-3885
Max T Billingsley, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 1 Shircliff Way, Emergency Department, Jacksonville, FL 32204 Phone: 904-346-5426 Fax: 904-346-0113
Kenneth Aung-din, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3625 University Blvd S, Jacksonville, FL 32216 Phone: 904-399-6811 Fax: 904-346-0113
Hannah Thomason Fox, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 4500 San Pablo Rd S, Jacksonville, FL 32224 Phone: 904-953-2000
Dr. Daniel R Eraso, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 655 W 8th St, Jacksonville, FL 32209 Phone: 904-244-6340 Fax: 904-244-4508
Paul D Lucey, MD Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 1 Shircliff Way, Jacksonville, FL 32204 Phone: 904-308-7300 Fax: 904-346-0113

Dr Grady Ausbur Fortner, MD - Medicare Emergency Medicine in Jacksonville, FL