Godly Obomate Jack, MD in Cartersville, GA - Medicare Internal Medicine

Godly Obomate Jack, MD is a medicare enrolled "Internal Medicine - Interventional Cardiology" physician in Cartersville, Georgia. His current practice location is 150 Gentilly Blvd, Cartersville, Georgia. You can reach out to his office (for appointments etc.) via phone at (470) 490-6670.

Godly Obomate Jack is licensed to practice in Georgia (license number 98756) 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 1114452588.

Contact Information

	Godly Obomate Jack, MD
	150 Gentilly Blvd, Cartersville, GA 30120-8522
	(470) 490-6670
	(770) 382-5762

Map and Direction

Physician's Profile

Full Name	Godly Obomate Jack
Gender	Male
Speciality	Internal Medicine - Interventional Cardiology
Location	150 Gentilly Blvd, Cartersville, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114452588
Provider Enumeration Date: 04/24/2017
Last Update Date: 06/20/2024

Medicare PECOS Information:

PECOS PAC ID: 0244508224
Enrollment ID: I20231101002354

Medical Identifiers

Medical identifiers for Godly Obomate Jack such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114452588	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207RC0000X	Internal Medicine - Cardiovascular Disease	98756 (Georgia)	Secondary
207RI0011X	Internal Medicine - Interventional Cardiology	98756 (Georgia)	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. Godly Obomate Jack allows following entities to bill medicare on his behalf.

Entity Name	Johns Hopkins Community Physicians
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1255359972 PECOS PAC ID: 8325943707 Enrollment ID: O20040130000162

Entity Name	Usacs Integrated Acute Care Services Of Maryland Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1922598929 PECOS PAC ID: 4486900172 Enrollment ID: O20190604001354

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. Godly Obomate Jack 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
Godly Obomate Jack, MD 221 Technology Pkwy Nw, Rome, GA 30165-1369 Ph: (762) 235-1000	Godly Obomate Jack, MD 150 Gentilly Blvd, Cartersville, GA 30120-8522 Ph: (470) 490-6670

Reviews and Comments

Internal Medicine Doctors in Cartersville, GA

Sanya Elizabeth Gayle, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 960 Joe Frank Harris Pkwy Se, Cartersville, GA 30120 Phone: 770-382-1530
Dr. Stacey Ikebudu, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 960 Joe Frank Harris Pkwy Se, Cartersville, GA 30120 Phone: 770-382-1530
Dr. Riaz Qadeer Gill, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 200 Gentilly Blvd, Cartersville, GA 30120 Phone: 470-490-6460 Fax: 470-490-6433
Dr. Srikanth Paladugu, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 960 Joe Frank Harris Pkwy Se, Cartersville, GA 30120 Phone: 770-382-1530
Dr. Christen Pirkle Subbiah, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 Courtyard Dr Se Ste B, Cartersville, GA 30120 Phone: 404-640-0206 Fax: 770-386-7910
Dr. Francisco Puentes, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 40 Fox Chase, Cartersville, GA 30120 Phone: 678-400-2621

Godly Obomate Jack, MD - Medicare Internal Medicine in Cartersville, GA