Ofundem Rose Gwan, MD is a medicare enrolled "General Practice" physician in Ruston, Louisiana. Her current practice location is
1406 S Vienna St, Ruston, Louisiana. You can reach out to her office (for appointments etc.) via phone at
(318) 232-2456.
Ofundem Rose Gwan is licensed to practice in Louisiana (license number MD.203609) 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 1245440940.
Physician's Profile
Full Name | Ofundem Rose Gwan |
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Gender | Female |
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Speciality | General Practice |
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Location | 1406 S Vienna St, Ruston, Louisiana |
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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: 1245440940
- Provider Enumeration Date: 05/23/2007
- Last Update Date: 01/23/2023
Medicare PECOS Information:
- PECOS PAC ID: 7517098098
- Enrollment ID: I20100628000224
Medical Identifiers
Medical identifiers for Ofundem Rose Gwan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1245440940 | NPI | - | NPPES |
1459330 | Medicaid | LA | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207R00000X | Internal Medicine | MD.203609 (Louisiana) | Secondary |
208D00000X | General Practice | MD.203609 (Louisiana) | 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. Ofundem Rose Gwan allows following entities to bill medicare on her behalf.
Entity Name | Hni Medical Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1366735169 PECOS PAC ID: 6406028810 Enrollment ID: O20141118000854 |
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Entity Name | Main Street Physician Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1396150785 PECOS PAC ID: 8022331909 Enrollment ID: O20141229001749 |
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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. Ofundem Rose Gwan 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 |
Ofundem Rose Gwan, MD 282 John Wayne Dr, Lafayette, LA 70508-4918 Ph: (337) 371-9670 | Ofundem Rose Gwan, MD 1406 S Vienna St, Ruston, LA 71270-6428 Ph: (318) 232-2456 |
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