Angela Jenkins, is a medicare enrolled "Social Worker - Clinical" provider in Fairfield, California. Her current practice location is
1234 Empire St, Fairfield, California. You can reach out to her office (for appointments etc.) via phone at
(707) 317-5554.
Angela Jenkins is licensed to practice in California (license number 108105) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1194167205.
Healthcare Provider's Profile
| Full Name | Angela Jenkins |
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| Gender | Female |
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| Speciality | Social Worker - Clinical |
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| Location | 1234 Empire St, Fairfield, California |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1194167205
- Provider Enumeration Date: 07/18/2013
- Last Update Date: 05/31/2023
Medicare PECOS Information:
- PECOS PAC ID: 1951757152
- Enrollment ID: I20231024003573
Medical Identifiers
Medical identifiers for Angela Jenkins such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1194167205 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 101YM0800X | Counselor - Mental Health | 86649 (California) | Secondary |
| 104100000X | Social Worker | 86649 (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 108105 (California) | 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. Angela Jenkins allows following entities to bill medicare on her behalf.
| Entity Name | Grow Healthcare Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154994846
PECOS PAC ID: 1850774746
Enrollment ID: O20220809004080 |
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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. Angela Jenkins 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 |
|---|
Angela Jenkins,
1234 Empire St,
Fairfield, CA 94533-5711
Ph: (707) 317-5554 | Angela Jenkins,
1234 Empire St,
Fairfield, CA 94533-5711
Ph: (707) 317-5554 |
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