Bryan J Prudhomme, MD - Medicare Pediatrics in Johnson City, TN

Bryan J Prudhomme, MD is a medicare enrolled "Pediatrics" physician in Johnson City, Tennessee. His current practice location is 301 Med Tech Pkwy, Ste. 180, Johnson City, Tennessee. You can reach out to his office (for appointments etc.) via phone at (423) 794-5540.

Bryan J Prudhomme is licensed to practice in Tennessee (license number 42204) 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 1528270816.

Contact Information

Bryan J Prudhomme, MD
301 Med Tech Pkwy, Ste. 180,
Johnson City, TN 37604
(423) 794-5540
(423) 926-3187



Physician's Profile

Full NameBryan J Prudhomme
GenderMale
SpecialityPediatrics
Location301 Med Tech Pkwy, Johnson City, Tennessee
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1528270816
  • Provider Enumeration Date: 05/07/2007
  • Last Update Date: 07/11/2018
  Medicare PECOS Information:
  • PECOS PAC ID: 9436241593
  • Enrollment ID: I20070817000706

Medical Identifiers

Medical identifiers for Bryan J Prudhomme such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1528270816NPI-NPPES
3000368MedicaidTN

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 42204 (Tennessee)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. Bryan J Prudhomme allows following entities to bill medicare on his behalf.
Entity NameState Of Franklin Healthcare Associates, Pllc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1063459410
PECOS PAC ID: 2466346291
Enrollment ID: O20040211001101

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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. Bryan J Prudhomme 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
Bryan J Prudhomme, MD
Po Box 3889,
Johnson City, TN 37602-3889

Ph: (423) 794-5540
Bryan J Prudhomme, MD
301 Med Tech Pkwy, Ste. 180,
Johnson City, TN 37604

Ph: (423) 794-5540

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Pediatrics Doctors in Johnson City, TN

John William Schweitzer, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604
Phone: 423-439-7320    
Mrs. Priya Narayanan Jain, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 325 N. State Of Franklin Road, Ground Fl, Johnson City, TN 37604
Phone: 423-439-7320    
Jodi B Gage, M.D.
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 325 N. State Of Franklin Road, Ground Floor, Johnson City, TN 37604
Phone: 423-439-7320    Fax: 423-439-7343
Dr. Demetrio Rebano Macariola Jr., MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604
Phone: 423-439-7320    Fax: 423-439-7343
Karen E Schetzina, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604
Phone: 423-439-7320    Fax: 423-439-7343
William Scott Dodd, M.D.
Pediatrics
Medicare: Accepting Medicare Assignments
Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604
Phone: 423-439-7320    Fax: 423-439-7343
Ahmad A Wattad, MD
Pediatrics
Medicare: Medicare Enrolled
Practice Location: 325 N State Of Franklin Rd, Ground Floor, Johnson City, TN 37604
Phone: 423-439-7320    Fax: 423-439-7343

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