NPIMap

Organization Active NPI

Munsayac Health LLC

  • Family Medicine Physician
  • Hazlehurst, GA
National Provider Identifier
1376068064
Registry record updated Sep 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
68251 Issued in GA
Legal business name
MUNSAYAC HEALTH LLC
Practice address
22 Cross St
Hazlehurst, GA 31539-6426
Phone
(912) 375-4884
Fax
(912) 375-4881
NPI assigned
Aug 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kirk Alessandro Munsayac, DONPI 1235361015
Title
Physician
Phone
(912) 375-4884

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 68251 GA Primary

Addresses

Primary practice location

22 Cross St
Hazlehurst, GA 31539-6426

Mailing address

22 Cross St
Hazlehurst, GA 31539-6426
Phone (912) 375-4884

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidGA

Other names 1

  • MUNSAYAC HEALTH LLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171002001903 GA Part B Supplier - Clinic/Group Practice 9436424470 Receives reassigned benefits from 2 practitioners
Practice locations: Hazlehurst, GA

National Provider Directory

National Provider Directory

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1501718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505260800000",
    "number": "1376068064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CROSS ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396426",
            "telephone_number": "912-375-4884",
            "fax_number": "912-375-4881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CROSS ST",
            "city": "HAZLEHURST",
            "state": "GA",
            "postal_code": "315396426",
            "telephone_number": "912-375-4884",
            "fax_number": "912-375-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNSAYAC HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-03",
        "last_updated": "2017-09-13",
        "status": "A",
        "authorized_official_last_name": "MUNSAYAC",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "ALESSANDRO",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "912-375-4884",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "68251",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MUNSAYAC HEALTH LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MUNSAYAC HEALTH LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hazlehurst, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.