Jeremy Zach Goodman, MD is a medicare enrolled "Urology" physician in Moultrie, Georgia. His current practice location is
16 Live Oak Ct, Moultrie, Georgia. You can reach out to his office (for appointments etc.) via phone at
(229) 891-9148.
Jeremy Zach Goodman is licensed to practice in Georgia (license number 101115) 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 1245890094.
Physician's Profile
| Full Name | Jeremy Zach Goodman |
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| Gender | Male |
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| Speciality | Urology |
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| Location | 16 Live Oak Ct, Moultrie, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1245890094
- Provider Enumeration Date: 06/14/2019
- Last Update Date: 08/02/2024
Medicare PECOS Information:
- PECOS PAC ID: 6103151477
- Enrollment ID: I20241011002702
Medical Identifiers
Medical identifiers for Jeremy Zach Goodman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245890094 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | 101115 (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. Jeremy Zach Goodman allows following entities to bill medicare on his behalf.
| Entity Name | Colquitt Regional Urology Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1215209416
PECOS PAC ID: 0840455192
Enrollment ID: O20120711000492 |
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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. Jeremy Zach Goodman 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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Jeremy Zach Goodman, MD
Po Box 2876,
Moultrie, GA 31776-2876
Ph: () - | Jeremy Zach Goodman, MD
16 Live Oak Ct,
Moultrie, GA 31768-6783
Ph: (229) 891-9148 |
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