Dr Grady Reynolds Fort, MD is a medicare enrolled "Pediatrics" physician in Livingston, California. He went to University Of California, San Francisco School Of Medicine and graduated in 1972 and has 52 years of diverse experience with area of expertise as Pediatric Medicine. He is a member of the group practice Mccloud Healthcare Clinic, Inc. and his current practice location is
1140 Main St, Livingston Medical Group, Livingston, California. You can reach out to his office (for appointments etc.) via phone at
(209) 394-7913.
Dr Grady Reynolds Fort is licensed to practice in California (license number G27353) 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 1982765582.
Physician's Profile
| Full Name | Dr Grady Reynolds Fort |
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| Gender | Male |
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| Speciality | Pediatric Medicine |
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| Experience | 52 Years |
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| Location | 1140 Main St, Livingston, California |
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| Accepts Medicare Assignments | Yes. He 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 Grady Reynolds Fort attended and graduated from University Of California, San Francisco School Of Medicine in 1972
NPI Data:
- NPI Number: 1982765582
- Provider Enumeration Date: 12/13/2006
- Last Update Date: 08/14/2024
Medicare PECOS Information:
- PECOS PAC ID: 2163522863
- Enrollment ID: I20070710001031
Medical Identifiers
Medical identifiers for Dr Grady Reynolds Fort such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982765582 | NPI | - | NPPES |
| 1982765582 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | G27353 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Mccloud Healthcare Clinic, Inc. | 3779494919 | 8 |
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 Reynolds Fort allows following entities to bill medicare on his behalf.
| Entity Name | Mccloud Healthcare Clinic, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1164428488
PECOS PAC ID: 3779494919
Enrollment ID: O20031118001091 |
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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 Grady Reynolds Fort 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 Grady Reynolds Fort, MD
116 W. Minnesota Ave,
Mccloud, CA 96057
Ph: (530) 964-2389 | Dr Grady Reynolds Fort, MD
1140 Main St, Livingston Medical Group,
Livingston, CA 95334-1257
Ph: (209) 394-7913 |
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