Crystal Dale, AGACNP in Gainesville, GA - Medicare Nurse Practitioner

Crystal Dale, AGACNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Gainesville, Georgia. She graduated from nursing school in 2015 and has 9 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Georgia Heart Institute Llc, Gwinnett Physician Group, Llc and her current practice location is 743 Spring St Ne, Gainesville, Georgia. You can reach out to her office (for appointments etc.) via phone at (770) 534-2020.

Crystal Dale is licensed to practice in Georgia (license number RN198451) 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 1245612654.

Contact Information

	Crystal Dale, AGACNP
	743 Spring St Ne, Gainesville, GA 30501-3715
	(770) 534-2020
	(770) 534-8025

Map and Direction

Provider's Profile

Full Name	Crystal Dale
Gender	Female
Speciality	Nurse Practitioner
Experience	9 Years
Location	743 Spring St Ne, Gainesville, Georgia
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:

Crystal Dale graduated from nursing school in 2015

NPI Data:

NPI Number: 1245612654
Provider Enumeration Date: 06/22/2015
Last Update Date: 02/24/2021

Medicare PECOS Information:

PECOS PAC ID: 9133420987
Enrollment ID: I20151221000625

Medical Identifiers

Medical identifiers for Crystal Dale such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1245612654	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LC0200X	Nurse Practitioner - Critical Care Medicine	RN198451 (Georgia)	Secondary
363LF0000X	Nurse Practitioner - Family	RN198451 (Georgia)	Secondary
363LG0600X	Nurse Practitioner - Gerontology	RN198451 (Georgia)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Northside Hospital Gwinnett	Lawrenceville, GA	Hospital
Northeast Georgia Medical Center, Inc	Gainesville, GA	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Georgia Heart Institute Llc	4183848062	107
Gwinnett Physician Group, Llc	9133211139	89

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. Crystal Dale allows following entities to bill medicare on her behalf.

Entity Name	Gwinnett Medical Group, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1780747469 PECOS PAC ID: 4284524166 Enrollment ID: O20040316000602

Entity Name	Gwinnett Physician Group, Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1578574661 PECOS PAC ID: 9133211139 Enrollment ID: O20070822001035

Entity Name	Georgia Heart Institute Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1477976520 PECOS PAC ID: 4183848062 Enrollment ID: O20140616001425

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. Crystal Dale 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
Crystal Dale, AGACNP Po Box 742616, Atlanta, GA 30374-2616 Ph: (770) 219-8420	Crystal Dale, AGACNP 743 Spring St Ne, Gainesville, GA 30501-3715 Ph: (770) 534-2020

Reviews and Comments

Nurse Practitioner Nurses in Gainesville, GA

Mrs. Nancy Fletcher Mccall, APRN-BC-CNSPMH Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4375 Spainhill Road, Gainesville, GA 30504 Phone: 770-654-4599
Shelley Charmaine Martin, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, GA 30501 Phone: 770-536-9864 Fax: 770-297-5025
Anela D Pearson, AGACNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 743 Spring St Ne, Gainesville, GA 30501 Phone: 770-534-2020 Fax: 770-534-8025
Terri Penna Kemmerer, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1240 Jesse Jewell Pkwy Se Ste 500, Gainesville, GA 30501 Phone: 770-536-9864 Fax: 770-297-5025
Bryan Scott Engel, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1250 Jesse Jewell Pkwy Se Ste 200, Gainesville, GA 30501 Phone: 770-297-7277
Laura J Banner, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1315 Jesse Jewell Pkwy Ne Ste 300, Gainesville, GA 30501 Phone: 770-219-6520
Molly Bruce, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1250 Jesse Jewell Pkwy Se Ste 200, Gainesville, GA 30501 Phone: 770-297-7277

Crystal Dale, AGACNP - Medicare Nurse Practitioner in Gainesville, GA