Hyde Park Medical - Medicare Primary Care in Antioch, TN

Hyde Park Medical is a medicare enrolled primary clinic (Family Medicine) in Antioch, Tennessee. The current practice location for Hyde Park Medical is 5380 Hickory Hollow Pkwy, Antioch, Tennessee. For appointments, you can reach them via phone at (615) 412-8662. The mailing address for Hyde Park Medical is Po Box 23, Gladeville, Tennessee and phone number is () -.

Hyde Park Medical is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1043903990. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (615) 412-8662.

Contact Information

Hyde Park Medical
5380 Hickory Hollow Pkwy
Antioch
TN 37013-3117
(615) 412-8662
Not Available

Primary Care Clinic Profile

Full NameHyde Park Medical
SpecialityFamily Medicine
Location5380 Hickory Hollow Pkwy, Antioch, Tennessee
Authorized Official Name and PositionKhaisha Gist (MEDICAL DIRECTOR)
Authorized Official Contact7738022723
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Hyde Park Medical
Po Box 23
Gladeville
TN 37071-0023

Ph: () -
Hyde Park Medical
5380 Hickory Hollow Pkwy
Antioch
TN 37013-3117

Ph: (615) 412-8662

NPI Details:

NPI Number1043903990
Provider Enumeration Date05/29/2023
Last Update Date07/23/2023

Medicare PECOS Information:

Medicare PECOS PAC ID7214397785
Medicare Enrollment IDO20230714003127

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Medical Identifiers

Medical identifiers for Hyde Park Medical such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1043903990NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine (* (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. Hyde Park Medical acts as a billing entity for following providers:
Provider NameKhaisha Verdelle Gist
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1184011835
PECOS PAC ID: 2961746219
Enrollment ID: I20181128000552

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