Sandra S Kopacz, MD is a medicare enrolled "Pediatrics" physician in Hawkinsville, Georgia. Her current practice location is
259 Broad St, Hawkinsville, Georgia. You can reach out to her office (for appointments etc.) via phone at
(478) 783-9340.
Sandra S Kopacz is licensed to practice in Georgia (license number 032179) 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 1396743803.
Physician's Profile
| Full Name | Sandra S Kopacz |
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| Gender | Female |
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| Speciality | Pediatrics |
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| Location | 259 Broad St, Hawkinsville, 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: 1396743803
- Provider Enumeration Date: 07/08/2005
- Last Update Date: 09/25/2023
Medicare PECOS Information:
- PECOS PAC ID: 6204075781
- Enrollment ID: I20130724000334
Medical Identifiers
Medical identifiers for Sandra S Kopacz such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1396743803 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | 032179 (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. Sandra S Kopacz allows following entities to bill medicare on her behalf.
| Entity Name | Taylor Regional Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1720189517
PECOS PAC ID: 6800795154
Enrollment ID: O20040426000736 |
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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. Sandra S Kopacz 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 |
|---|
Sandra S Kopacz, MD
259 Broad St,
Hawkinsville, GA 31036-4818
Ph: (478) 300-7107 | Sandra S Kopacz, MD
259 Broad St,
Hawkinsville, GA 31036-4818
Ph: (478) 783-9340 |
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