Holly Krysiak, MD is a medicare enrolled "Emergency Medicine" physician in Altanta, Georgia. Her current practice location is
49 Jesse Hill Dr Se, Altanta, Georgia. You can reach out to her office (for appointments etc.) via phone at
(404) 616-6673.
Holly Krysiak is licensed to practice in Georgia (license number 003186) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1760645576.
Physician's Profile
Full Name | Holly Krysiak |
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Gender | Female |
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Speciality | Emergency Medicine |
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Location | 49 Jesse Hill Dr Se, Altanta, Georgia |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1760645576
- Provider Enumeration Date: 07/02/2008
- Last Update Date: 06/23/2009
Medicare PECOS Information:
- PECOS PAC ID: 1456539808
- Enrollment ID: I20110707000180
Medical Identifiers
Medical identifiers for Holly Krysiak such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760645576 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207P00000X | Emergency Medicine | 003186 (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. Holly Krysiak allows following entities to bill medicare on her behalf.
Entity Name | Cartersville Emergency Physicians, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1346295995 PECOS PAC ID: 5193776458 Enrollment ID: O20050203000370 |
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Entity Name | The Bortolazzo Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1801965082 PECOS PAC ID: 3476554320 Enrollment ID: O20070122000015 |
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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. Holly Krysiak 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 |
Holly Krysiak, MD 1777 Piedmont Way Ne, Apt A, Atlanta, GA 30324-5127 Ph: () - | Holly Krysiak, MD 49 Jesse Hill Dr Se, Altanta, GA 30303-3002 Ph: (404) 616-6673 |
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