Keontra Tyes, - Medicare Audiologist in Decatur, GA

Keontra Tyes, is a medicare enrolled "Audiologist" provider in Decatur, Georgia. Her current practice location is 484 Irvin Ct, Decatur, Georgia. You can reach out to her office (for appointments etc.) via phone at (404) 297-4248.

Keontra Tyes is licensed to practice in Georgia (license number AUD004381) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1134802630.

Contact Information

Keontra Tyes,
484 Irvin Ct,
Decatur, GA 30030-5406
(404) 297-4248
Not Available



Healthcare Provider's Profile

Full NameKeontra Tyes
GenderFemale
SpecialityAudiologist
Location484 Irvin Ct, Decatur, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1134802630
  • Provider Enumeration Date: 08/10/2023
  • Last Update Date: 08/10/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 7517320930
  • Enrollment ID: I20230831002627

Medical Identifiers

Medical identifiers for Keontra Tyes such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134802630NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
231H00000XAudiologist AUD004381 (Georgia)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. Keontra Tyes allows following entities to bill medicare on her behalf.
Provider NameGeorgia Surgical Professional Services Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1801224506
PECOS PAC ID: 3375774011
Enrollment ID: O20140324000595

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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. Keontra Tyes 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 AddressPractice Location Address
Keontra Tyes,
484 Irvin Ct,
Decatur, GA 30030-5406

Ph: (404) 297-4248
Keontra Tyes,
484 Irvin Ct,
Decatur, GA 30030-5406

Ph: (404) 297-4248

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Audiologist in Decatur, GA

Deborah Sharon Golden, MS
Audiologist
Medicare: Medicare Enrolled
Practice Location: 2726 Lawrenceville Highway, Decatur, GA 30033
Phone: 770-414-1130    Fax: 770-414-1135
Bradley Hess, AU.D.
Audiologist
Medicare: Not Enrolled in Medicare
Practice Location: 1670 Clairmont Rd, Audiology And Speech Pathology (126), Decatur, GA 30033
Phone: 404-235-3036    
Ashley Brock, AU.D.
Audiologist
Medicare: Not Enrolled in Medicare
Practice Location: 1670 Clairmont Rd, Decatur, GA 30033
Phone: 404-321-6111    
Chelsea Kilgore, AUD
Audiologist
Medicare: Medicare Enrolled
Practice Location: 1991 N Williamsburg Dr Ste A, Decatur, GA 30033
Phone: 404-500-1026    Fax: 404-478-6476
Dr. Steven Lamar Benton, AU.D.
Audiologist
Medicare: Not Enrolled in Medicare
Practice Location: 1670 Clairmont Rd, Audiology (126), Decatur, GA 30033
Phone: 404-329-4655    
Ms. Sue Ellen Basore, MS
Audiologist
Medicare: Not Enrolled in Medicare
Practice Location: 1670 Clairmont Rd, Decatur, GA 30033
Phone: 404-329-4656    Fax: 404-728-5074

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