Dr Kushna K Damallie, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Clarksdale, Mississippi. He went to Boston University School Of Medicine and graduated in 1999 and has 25 years of diverse experience with area of expertise as Obstetrics/gynecology. He is a member of the group practice Womans Clinic, A Professional Association and his current practice location is
2000 N State St, Clarksdale, Mississippi. You can reach out to his office (for appointments etc.) via phone at
(662) 627-7361.
Dr Kushna K Damallie is licensed to practice in Tennessee (license number 35758) 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 1861488215.
Physician's Profile
| Full Name | Dr Kushna K Damallie |
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| Gender | Male |
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| Speciality | Obstetrics/gynecology |
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| Experience | 25 Years |
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| Location | 2000 N State St, Clarksdale, Mississippi |
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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 Kushna K Damallie attended and graduated from Boston University School Of Medicine in 1999
NPI Data:
- NPI Number: 1861488215
- Provider Enumeration Date: 09/21/2005
- Last Update Date: 01/11/2023
Medicare PECOS Information:
- PECOS PAC ID: 6103984588
- Enrollment ID: I20220602003104
Medical Identifiers
Medical identifiers for Dr Kushna K Damallie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1861488215 | NPI | - | NPPES |
| 09035591 | Medicaid | MS | |
| 150159001 | Other | MS | ARK MEDICAID |
| 82604 | Other | MS | ARK BCBS |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207V00000X | Obstetrics & Gynecology | 35758 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Womans Clinic, A Professional Association | 1254228067 | 5 |
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 Kushna K Damallie allows following entities to bill medicare on his behalf.
| Entity Name | Ut Regional One Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093130585
PECOS PAC ID: 5698993418
Enrollment ID: O20140820000662 |
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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 Kushna K Damallie 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 Kushna K Damallie, MD
2000 N State St,
Clarksdale, MS 38614-6100
Ph: (662) 627-7361 | Dr Kushna K Damallie, MD
2000 N State St,
Clarksdale, MS 38614-6100
Ph: (662) 627-7361 |
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