Katia Fayola Outlaw, in Atlanta, GA - Medicare Nurse Practitioner

Katia Fayola Outlaw, is a medicare enrolled "Nurse Practitioner - Family" in Atlanta, Georgia. Her current practice location is 550 Peachtree St Ne Ste 1600, Atlanta, Georgia. You can reach out to her office (for appointments etc.) via phone at (404) 298-8998.

Katia Fayola Outlaw is licensed to practice in North Carolina (license number 281863) 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 1720495021.

Contact Information

	Katia Fayola Outlaw,
	550 Peachtree St Ne Ste 1600, Atlanta, GA 30308-2246
	(404) 298-8998
	Not Available

Map and Direction

Provider's Profile

Full Name	Katia Fayola Outlaw
Gender	Female
Speciality	Nurse Practitioner - Family
Location	550 Peachtree St Ne Ste 1600, Atlanta, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1720495021
Provider Enumeration Date: 07/18/2014
Last Update Date: 03/06/2020

Medicare PECOS Information:

PECOS PAC ID: 8527379304
Enrollment ID: I20171016000989

Medical Identifiers

Medical identifiers for Katia Fayola Outlaw such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1720495021	NPI	-	NPPES
NP3723	Medicaid	SC
1720495021	Medicaid	NC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
163W00000X	Registered Nurse	4704254995 (Michigan)	Secondary
363LF0000X	Nurse Practitioner - Family	4704254995 (Michigan)	Secondary
363LF0000X	Nurse Practitioner - Family	281863 (North Carolina)	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. Katia Fayola Outlaw allows following entities to bill medicare on her behalf.

Entity Name	Medcura Health, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417011487 PECOS PAC ID: 2961443643 Enrollment ID: O20120509000245

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. Katia Fayola Outlaw 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
Katia Fayola Outlaw, 5582 Memorial Dr, Stone Mountain, GA 30083-3215 Ph: (404) 307-4445	Katia Fayola Outlaw, 550 Peachtree St Ne Ste 1600, Atlanta, GA 30308-2246 Ph: (404) 298-8998

Reviews and Comments

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Katia Fayola Outlaw, - Medicare Nurse Practitioner in Atlanta, GA