Mr Ledontrae Gooden, PA-C in Fort Moore, GA - Medicare Physician Assistant

Mr Ledontrae Gooden, PA-C is a medicare enrolled "Physician Assistant - Medical" in Fort Moore, Georgia. His current practice location is 6600 Van Aalst Blvd, Fort Moore, Georgia. You can reach out to his office (for appointments etc.) via phone at (916) 385-1006.

Mr Ledontrae Gooden is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1528607272.

Contact Information

	Mr Ledontrae Gooden, PA-C
	6600 Van Aalst Blvd, Fort Moore, GA 31905-2102
	(916) 385-1006
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Ledontrae Gooden
Gender	Male
Speciality	Physician Assistant - Medical
Location	6600 Van Aalst Blvd, Fort Moore, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1528607272
Provider Enumeration Date: 12/28/2019
Last Update Date: 01/22/2024

Medicare PECOS Information:

PECOS PAC ID: 7911370689
Enrollment ID: I20230228000324

Medical Identifiers

Medical identifiers for Mr Ledontrae Gooden such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1528607272	NPI	-	NPPES
NONE	Other		NONE

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363AM0700X	Physician Assistant - Medical	(* (Not Available))	Primary
172A00000X	Driver	(* (Not Available))	Secondary

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. Mr Ledontrae Gooden 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
Mr Ledontrae Gooden, PA-C 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905-2102 Ph: (916) 385-1006	Mr Ledontrae Gooden, PA-C 6600 Van Aalst Blvd, Fort Moore, GA 31905-2102 Ph: (916) 385-1006

Reviews and Comments

Physician Assistant Nurses in Fort Moore, GA

Jenna Elizabeth Frost, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: Martin Army Community Hospital, 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905 Phone: 706-544-9516
Scott Merideth Gilpatrick, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6600 Van Aalst Blvd Bldg 9520, Fort Moore, GA 31905 Phone: 706-545-8512
John Franklin Rains, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6600 Van Aalst Blvd, Fort Moore, GA 31905 Phone: 762-408-1402
Jordan Burgess, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 6600 Van Aalst Blvd Bldg 9250, Fort Moore, GA 31905 Phone: 402-806-2909
Brian A Pineda, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 6600 Van Aalst Blvd, Fort Moore, GA 31905 Phone: 762-408-0374
Mr. Jerry Lyle Starr, PA-C Physician Assistant Medicare: Medicare Enrolled Practice Location: 6600 Van Aalst Blvd, Fort Moore, GA 31905 Phone: 762-408-1374
Mr. Christopher Whitaker, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 6600 Van Aalst Blvd, Fort Moore, GA 31905 Phone: 762-408-0374

Mr Ledontrae Gooden, PA-C - Medicare Physician Assistant in Fort Moore, GA