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MYRNA GACUSAN
NPI 1174976088
Nurse Practitioner - Family in Jonesboro, GA

Active since July 14, 2016PECOS Enrolled
6911 TARA BLVD, JONESBORO, GA 30236(770) 477-8573(770) 477-8573 Get Directions Write a Review

NPPES record last updated: July 14, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Myrna Gacusan NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYRNA GACUSAN (NPI 1174976088) is an individual family provider in Jonesboro, Georgia, licensed in Georgia (151283) and active in the NPI registry since July 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1174976088
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameMYRNA GACUSAN
Location Address6911 TARA BLVDJonesboro, GA 30236-1503
Mailing Address4395 Abbotts Pointe CtDuluth, GA 30097-2199
Phone(770) 477-8573
Fax(770) 477-8573
Sole ProprietorNo
Enumeration DateJuly 14, 2016
✔ NPI 1174976088 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · 151283
6911 TARA BLVD, Jonesboro, GA 30236
Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Myrna Gacusan is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Myrna Gacusan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Infectious Disease Consultants, PC
38 mi
Infectious Disease
5400 LAUREL SPRINGS PKWY STE 1404
Suwanee, GA 30024
  • Reassigned Medicare billing, Georgia enrollment
  • 13 clinicians in this Medicare group
NPI 1225087745 (678) 347-2153
Transitional Care Physicians Of Georgia PC
40 mi
Specialist
704 BREEDLOVE DR, STE A
Monroe, GA 30655
  • Reassigned Medicare billing, Georgia enrollment
  • 71 clinicians in this Medicare group
NPI 1619317542 (888) 772-0076

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30236 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims 10

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Walker, folding, wheeled, adjustable or fixed height E0143
DME-Other DME · category DE000N
3 suppliers12 claims12 services$46.50 avg. paid by Medicare
Commode chair, mobile or stationary, with detachable arms E0165
DME-Other DME · category DE000N
1 supplier11 claims11 services$8.56 avg. paid by Medicare
Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
3 suppliers58 claims58 services$40.31 avg. paid by Medicare
Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
2 suppliers14 claims14 services$14.00 avg. paid by Medicare
Transport chair, adult size, patient weight capacity up to and including 300 pounds E1038
DME-Other DME · category DE000N
4 suppliers26 claims26 services$9.52 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
2 suppliers27 claims27 services$66.98 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CLAYTON MOBILE DIAGNOSTIC CLINIC
Podiatrist
6911 TARA BLVD
JONESBORO, GA 30236
Clayton County (770) 477-9535
ATLANTA FOOT AND LEG CLINIC
Podiatrist (Foot & Ankle Surgery)
6911 TARA BLVD, SUITE 101
JONESBORO, GA 30236
Clayton County (770) 477-9535
CLAYTON OUTPATIENT SURGICAL CENTER
Clinic/Center (Ambulatory Surgical)
6911 TARA BLVD, SUITE 104
JONESBORO, GA 30236
Clayton County (770) 477-9535
MIKE Y. TAN, M.D.P.C.
Case Management
6911 TARA BLVD, SUITE 111
JONESBORO, GA 30236
Clayton County (770) 478-2057
NON-HEALING WOUND CENTERS OF ATLANTA
Clinic/Center (Podiatric)
6911 TARA BLVD
JONESBORO, GA 30236
Clayton County (770) 477-9535
DR. STANLEY RICHARD KALISH DPM
Podiatrist (Foot & Ankle Surgery)
6911 TARA BLVD
JONESBORO, GA 30236
Clayton County (770) 477-9535

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Myrna Gacusan's NPI number?

The NPI number for Myrna Gacusan is 1174976088. It was assigned to this individual provider in the NPPES registry on July 14, 2016.

Where is Myrna Gacusan located?

Myrna Gacusan practices at 6911 Tara Blvd, Jonesboro, GA 30236. The listed phone number is (770) 477-8573.

What is Myrna Gacusan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Myrna Gacusan enrolled in Medicare?

Yes. Myrna Gacusan is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Myrna Gacusan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Myrna Gacusan reassigns Medicare benefits to 2 organizations: Infectious Disease Consultants, PC (Suwanee, GA) and Transitional Care Physicians Of Georgia PC (Monroe, GA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Myrna Gacusan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Myrna Gacusan was last updated on July 14, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.