Dr Jackson L Gates, MD is a medicare enrolled "General Practice" physician in Conyers, Georgia. He went to Medical College Of Georgia School Of Medicine and graduated in 1992 and has 32 years of diverse experience with area of expertise as General Practice. His current practice location is
1880 Lancaster Drive, Conyers, Georgia. You can reach out to his office (for appointments etc.) via phone at
(678) 591-6509.
Dr Jackson L Gates is licensed to practice in Georgia (license number 038767) 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 1962418400.
Physician's Profile
Full Name | Dr Jackson L Gates |
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Gender | Male |
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Speciality | General Practice |
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Experience | 32 Years |
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Location | 1880 Lancaster Drive, Conyers, Georgia |
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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. |
Medical Education and Training:
- Dr Jackson L Gates attended and graduated from Medical College Of Georgia School Of Medicine in 1992
NPI Data:
- NPI Number: 1962418400
- Provider Enumeration Date: 08/01/2006
- Last Update Date: 08/10/2010
Medicare PECOS Information:
- PECOS PAC ID: 2163618554
- Enrollment ID: I20101124000670
Medical Identifiers
Medical identifiers for Dr Jackson L Gates such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1962418400 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 038767 (Georgia) | Primary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 038767 (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 Jackson L Gates allows following entities to bill medicare on his behalf.
Entity Name | Prime Care & Pathology Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1144977802 PECOS PAC ID: 4688061294 Enrollment ID: O20220429001112 |
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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 Jackson L Gates 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 Jackson L Gates, MD 777 Cleveland Ave Sw, Suite 100, Atlanta, GA 30315-7129 Ph: (404) 763-0093 | Dr Jackson L Gates, MD 1880 Lancaster Drive, Conyers, GA 30013-6433 Ph: (678) 591-6509 |
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