Kisa W Seymore, MD is a medicare enrolled "Dermatology" physician in Cedartown, Georgia. She went to East Tennessee State University Quillen College Of Medicine and graduated in 2004 and has 20 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Skin Cancer And Cosmetic Dermatology Center Pc and her current practice location is
1025 N Main St, Cedartown, Georgia. You can reach out to her office (for appointments etc.) via phone at
(770) 748-0076.
Kisa W Seymore is licensed to practice in Georgia (license number 4221) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1841200375.
Physician's Profile
Full Name | Kisa W Seymore |
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Gender | Female |
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Speciality | Family Practice |
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Experience | 20 Years |
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Location | 1025 N Main St, Cedartown, Georgia |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Kisa W Seymore attended and graduated from East Tennessee State University Quillen College Of Medicine in 2004
NPI Data:
- NPI Number: 1841200375
- Provider Enumeration Date: 08/08/2006
- Last Update Date: 11/27/2023
Medicare PECOS Information:
- PECOS PAC ID: 2163428707
- Enrollment ID: I20120822000741
Medical Identifiers
Medical identifiers for Kisa W Seymore such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1841200375 | NPI | - | NPPES |
003125281A | Medicaid | GA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 4221 (Georgia) | Secondary |
207N00000X | Dermatology | 4221 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Skin Cancer And Cosmetic Dermatology Center Pc | 3375591209 | 19 |
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. Kisa W Seymore allows following entities to bill medicare on her behalf.
Entity Name | Skin Cancer & Cosmetic Dermatology Center Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1376605394 PECOS PAC ID: 3375591209 Enrollment ID: O20050107000373 |
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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. Kisa W Seymore 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 |
Kisa W Seymore, MD 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 Ph: (706) 509-3000 | Kisa W Seymore, MD 1025 N Main St, Cedartown, GA 30125-2036 Ph: (770) 748-0076 |
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