Kenette St-gourdin, MD in Marietta, GA - Medicare Internal Medicine

Kenette St-gourdin, MD is a medicare enrolled "Internal Medicine" physician in Marietta, Georgia. Her current practice location is 631 Campbell Hill St Nw Ste 200, Marietta, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 727-4130.

Kenette St-gourdin is licensed to practice in Georgia (license number 96398) 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 1619506557.

Contact Information

	Kenette St-gourdin, MD
	631 Campbell Hill St Nw Ste 200, Marietta, GA 30060-1390
	(770) 727-4130
	(770) 800-1334

Map and Direction

Physician's Profile

Full Name	Kenette St-gourdin
Gender	Female
Speciality	Internal Medicine
Location	631 Campbell Hill St Nw Ste 200, Marietta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1619506557
Provider Enumeration Date: 04/03/2020
Last Update Date: 12/04/2024

Medicare PECOS Information:

PECOS PAC ID: 1153768072
Enrollment ID: I20240327000391

Medical Identifiers

Medical identifiers for Kenette St-gourdin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1619506557	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208M00000X	Hospitalist	2023049186 (Missouri)	Secondary
390200000X	Student In An Organized Health Care Education/training Program	(* (Not Available))	Secondary
207R00000X	Internal Medicine	96398 (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. Kenette St-gourdin allows following entities to bill medicare on her behalf.

Entity Name	Physician Groups Lc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285664268 PECOS PAC ID: 3072421254 Enrollment ID: O20040220001157

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. Kenette St-gourdin 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
Kenette St-gourdin, MD 631 Campbell Hill St Nw Ste 200, Marietta, GA 30060-1390 Ph: (314) 448-3791	Kenette St-gourdin, MD 631 Campbell Hill St Nw Ste 200, Marietta, GA 30060-1390 Ph: (770) 727-4130

Reviews and Comments

Internal Medicine Doctors in Marietta, GA

Anu Kurl, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 400 Tower Rd Ne Ste 160, Marietta, GA 30060 Phone: 770-420-1690 Fax: 770-420-1661
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Dr. Helga Annalina Bahr, M.D. Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 580 Atlanta Country Club Drive, Marietta, GA 30068 Phone: 770-988-8554
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Dr. Ryan V Cantwell, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 320 Kennestone Hospital Blvd, Suite 201, Marietta, GA 30060 Phone: 770-427-2457 Fax: 770-427-2706
Dr. Joanne Zhiwen Zhu, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 677 Church St Ne # 111, Marietta, GA 30060 Phone: 770-793-7750

Kenette St-gourdin, MD - Medicare Internal Medicine in Marietta, GA