Mr Mark David Roman, PA-C in Dallas, GA - Medicare Physician Assistant

Mr Mark David Roman, PA-C is a medicare enrolled "Physician Assistant" in Dallas, Georgia. His current practice location is 225 Mary Wallace Way, Dallas, Georgia. You can reach out to his office (for appointments etc.) via phone at (770) 608-3302.

Mr Mark David Roman is licensed to practice in Florida (license number PA9101641) 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 1588692602.

Contact Information

	Mr Mark David Roman, PA-C
	225 Mary Wallace Way, Dallas, GA 30157-5054
	(770) 608-3302
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Mark David Roman
Gender	Male
Speciality	Physician Assistant
Location	225 Mary Wallace Way, Dallas, Georgia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1588692602
Provider Enumeration Date: 06/29/2006
Last Update Date: 08/13/2018

Medicare PECOS Information:

PECOS PAC ID: 6305866054
Enrollment ID: I20151008002146

Medical Identifiers

Medical identifiers for Mr Mark David Roman such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1588692602	NPI	-	NPPES
291095100	Medicaid	FL

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	PA9101641 (Florida)	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. Mr Mark David Roman allows following entities to bill medicare on his behalf.

Entity Name	Memorial Hospital Association
Entity Type	Part A Provider - Critical Access Hospital
Entity Identifiers	NPI Number: 1336119338 PECOS PAC ID: 1951375849 Enrollment ID: O20061104000636

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 Mark David Roman 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 Mark David Roman, PA-C 10 Kruger Rd, Plains, MT 59859-9271 Ph: (406) 826-4800	Mr Mark David Roman, PA-C 225 Mary Wallace Way, Dallas, GA 30157-5054 Ph: (770) 608-3302

Reviews and Comments

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Mr Mark David Roman, PA-C - Medicare Physician Assistant in Dallas, GA