Specialist In Enterprise Alabama

NPI list of 9 specialist registered providers with a business address in Enterprise, AL of which 5 are registered as organizations and 4 as individuals. An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

NPI Name Type Taxonomy Address Medicare PECOS
1023077013GILBERT LEE MCDONOUGHIndividualSpecialist207 E WATTS ST SUITE 200
ENTERPRISE, AL 36330
(334) 347-4646
Non-Participating ProviderNO
1154489516LISA GAY WADEIndividualSpecialist557 GLOVER AVE STE 5
ENTERPRISE, AL 36330
(334) 347-0234
Non-Participating ProviderNO
1295283752CRISTINA ORTIZ-LYNONIndividualSpecialist
(Prosthetics Case Management)
1227 RUCKER BLVD
ENTERPRISE, AL 36330
(334) 347-1221
Non-Participating ProviderNO
1487708731SOUTHEASTERN ENT, P.C.OrganizationSpecialist107 E WATTS ST
ENTERPRISE, AL 36330
(334) 393-6837
Non-Participating ProviderNO
1538465323DERMATOLOGY ASSOCIATES OF DOTHAN, LLC
DERMATOLOGY ASSOCIATES OF DOTHAN
OrganizationSpecialist101 PROFESSIONAL LN
ENTERPRISE, AL 36330
(334) 347-3404
Non-Participating ProviderNO
1578686531DOLORES L. MARTINIndividualSpecialist2841 NEAL METCALF RD
ENTERPRISE, AL 36330
(334) 393-1011
Non-Participating ProviderNO
1588745277WEST SURGICAL PAOrganizationSpecialist101 E BRUNSON ST SUITE 110
ENTERPRISE, AL 36330
(334) 347-9355
Non-Participating ProviderNO
1639266018DANIEL E. GADZALA, M.D.OrganizationSpecialist101 E BRUNSON ST SUITE 110
ENTERPRISE, AL 36330
(334) 347-9355
Non-Participating ProviderNO
1982806352MCDONOUGH OBGYNOrganizationSpecialist207 E WATTS ST SUITE 200
ENTERPRISE, AL 36330
(334) 347-4646
Non-Participating ProviderNO

Medicare Participation

  • Participating providers are registered with Medicare and accept claims assignment. Taking claims assignment means the provider accepts Medicare's approved amount for the cost of rendered services as full payment. Participating providers may not charge Medicare beneficiaries more than Medicare's approved amount for their services. Medicare beneficiaries still have to pay a coinsurance or co-payment amount for a visit or service.
  • Non-Participating providers do not agree to take Medicare claims assignment. If you are a Medicare beneficiary this means the provider can charge up to 15% more than Medicare's approved amount for the cost of rendered services, in addition to your normal deductible and coinsurance costs. There are some states that restrict the limiting charge when you see non-participating provider. If you pay the full cost of your care up front, your non- participating provider should still submit a claim to Medicare. Afterward, you should receive reimbursement from Medicare for up 80% of the Medicare-approved amount for the services rendered.
  • Opt-out providers signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so.

What is PECOS?

PECOS is Medicare's enrollment and revalidation system and it is the primary source of information about verified Medicare professionals eligible to order or refer healthcare services for Medicare patients.