Gregory Jackson Aycock, CAA is a medicare enrolled "Anesthesiologist Assistant" provider in Saint Louis, Missouri. His current practice location is
615 S New Ballas Rd Dept Of, Saint Louis, Missouri. You can reach out to his office (for appointments etc.) via phone at
(636) 386-9224.
Gregory Jackson Aycock is licensed to practice in Missouri (license number PENDING) 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 1215924527.
Healthcare Provider's Profile
| Full Name | Gregory Jackson Aycock |
|---|
| Gender | Male |
|---|
| Speciality | Anesthesiologist Assistant |
|---|
| Location | 615 S New Ballas Rd Dept Of, Saint Louis, Missouri |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1215924527
- Provider Enumeration Date: 10/03/2005
- Last Update Date: 11/21/2024
Medicare PECOS Information:
- PECOS PAC ID: 0547614059
- Enrollment ID: I20240604000162
Medical Identifiers
Medical identifiers for Gregory Jackson Aycock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1215924527 | NPI | - | NPPES |
| 1103727700 | Other | IN | ANTHEM PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 183500000X | Pharmacist | PS40328 (Florida) | Secondary |
| 183500000X | Pharmacist | 17641 (North Carolina) | Secondary |
| 367H00000X | Anesthesiologist Assistant | 75000176A (Indiana) | Secondary |
| 367H00000X | Anesthesiologist Assistant | PENDING (Missouri) | 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. Gregory Jackson Aycock allows following entities to bill medicare on his behalf.
| Entity Name | Iu Anesthesiology Associates, Llc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1285684407
PECOS PAC ID: 5395730303
Enrollment ID: O20040419001228 |
|---|
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. Gregory Jackson Aycock 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 |
|---|
Gregory Jackson Aycock, CAA
339 Consort Dr,
Ballwin, MO 63011-4439
Ph: (636) 386-9224 | Gregory Jackson Aycock, CAA
615 S New Ballas Rd Dept Of,
Saint Louis, MO 63141-8221
Ph: (636) 386-9224 |
Reviews and Comments