Integrative Performance Medical Group, Pllc is a medicare enrolled "Specialist" provider in Edwardsville, Illinois. Their current practice location is
200 S Buchanan St, Edwardsville, Illinois. You can reach out to their office (for appointments etc.) via phone at
(618) 659-8889.
Integrative Performance Medical Group, Pllc is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Integrative Performance Medical Group, Pllc
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1699232637.
Healthcare Provider's Profile
| Full Name | Integrative Performance Medical Group, Pllc |
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| Type | Facility |
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| Speciality | Specialist |
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| Location | 200 S Buchanan St, Edwardsville, Illinois |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699232637
- Provider Enumeration Date: 02/26/2019
- Last Update Date: 02/26/2019
Medicare PECOS Information:
- PECOS PAC ID: 9436548542
- Enrollment ID: O20211111000607
Medical Identifiers
Medical identifiers for Integrative Performance Medical Group, Pllc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699232637 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 174400000X | Specialist | (* (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.
Integrative Performance Medical Group, Pllc acts as a billing entity for following providers:
| Provider Name | Jeremy R Clark |
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| Provider Type | Practitioner - Chiropractic |
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| Provider Identifiers | NPI Number: 1710018395
PECOS PAC ID: 0143275024
Enrollment ID: I20050314000585 |
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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. Integrative Performance Medical Group, Pllc 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 Address | Practice Location Address |
|---|
Integrative Performance Medical Group, Pllc
200 S Buchanan St,
Edwardsville, IL 62025-2109
Ph: (618) 659-8889 | Integrative Performance Medical Group, Pllc
200 S Buchanan St,
Edwardsville, IL 62025-2109
Ph: (618) 659-8889 |
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