Mr Jonathan David Derryberry Jr, CAA - Medicare Anesthesiologist Assistant in Rome, GA

Mr Jonathan David Derryberry Jr, CAA is a medicare enrolled "Anesthesiologist Assistant" in Rome, Georgia. His current practice location is 304 Turner Mccall Blvd Sw, Rome, Georgia. You can reach out to his office (for appointments etc.) via phone at (404) 727-5910.

Mr Jonathan David Derryberry Jr is licensed to practice in * (Not Available) (license number ) 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 1831779578.

Contact Information

Mr Jonathan David Derryberry Jr, CAA
304 Turner Mccall Blvd Sw,
Rome, GA 30165-5621
(404) 727-5910
Not Available



Provider's Profile

Full NameMr Jonathan David Derryberry Jr
GenderMale
SpecialityAnesthesiologist Assistant
Location304 Turner Mccall Blvd Sw, Rome, Georgia
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1831779578
  • Provider Enumeration Date: 04/08/2021
  • Last Update Date: 12/15/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 3678945714
  • Enrollment ID: I20230217001966

Medical Identifiers

Medical identifiers for Mr Jonathan David Derryberry Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1831779578NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367H00000XAnesthesiologist Assistant (* (Not Available))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. Mr Jonathan David Derryberry Jr allows following entities to bill medicare on his behalf.
Entity NameGeorgia Group Services, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1093947236
PECOS PAC ID: 0840338018
Enrollment ID: O20091109000203

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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. Mr Jonathan David Derryberry Jr 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
Mr Jonathan David Derryberry Jr, CAA
304 Turner Mccall Blvd Sw,
Rome, GA 30165-5621

Ph: () -
Mr Jonathan David Derryberry Jr, CAA
304 Turner Mccall Blvd Sw,
Rome, GA 30165-5621

Ph: (404) 727-5910

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Anesthesiologist Assistant Nurses in Rome, GA

Douglas E Mcniece, PA
Anesthesiologist Assistant
Medicare: Medicare Enrolled
Practice Location: 501 Redmond Rd Nw, Anesthesiology Department, Rome, GA 30165
Phone: 706-291-0291    
Jeffrey Lee Mahoney, PA
Anesthesiologist Assistant
Medicare: Medicare Enrolled
Practice Location: 501 Redmond Rd Nw, Rome, GA 30165
Phone: 706-291-0291    
Stephen Mark Walker, PAAA
Anesthesiologist Assistant
Medicare: Not Enrolled in Medicare
Practice Location: 330 Turner Mccall Blvd Sw, Rome, GA 30165
Phone: 706-802-2000    Fax: 706-233-9846
Mr. Harry Mallette Peagler Iv, AA
Anesthesiologist Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 304 Turner Mccall Blvd Sw, Rome, GA 30165
Phone: 706-509-5000    
Mr. Charles E. Hufstetler, AA
Anesthesiologist Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 501 Redmond Rd Nw, Rome, GA 30165
Phone: 706-291-0291    
Mr. Billy Don Deberry Iii,
Anesthesiologist Assistant
Medicare: Medicare Enrolled
Practice Location: 304 Turner Mccall Blvd Sw, Rome, GA 30165
Phone: 706-509-5000    
Magdalene Jo Magee, PA
Anesthesiologist Assistant
Medicare: Medicare Enrolled
Practice Location: 501 Redmond Rd Nw, Anesthesiology Department, Rome, GA 30165
Phone: 706-368-8022    Fax: 706-368-8452

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