Fatima Jalloh, is a medicare enrolled "Social Worker - Clinical" provider in Roseburg, Oregon. Her current practice location is
3005 Ne Diamond Lake Blvd, Roseburg, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 440-3532.
Fatima Jalloh is licensed to practice in Oregon (license number L11796) 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 1922612035.
Healthcare Provider's Profile
Full Name | Fatima Jalloh |
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Gender | Female |
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Speciality | Social Worker - Clinical |
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Location | 3005 Ne Diamond Lake Blvd, Roseburg, Oregon |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1922612035
- Provider Enumeration Date: 09/04/2020
- Last Update Date: 09/23/2024
Medicare PECOS Information:
- PECOS PAC ID: 2062956766
- Enrollment ID: I20240705001986
Medical Identifiers
Medical identifiers for Fatima Jalloh such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1922612035 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
101YM0800X | Counselor - Mental Health | 1041C0700X (Oregon) | Secondary |
1041C0700X | Social Worker - Clinical | L11796 (Oregon) | 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. Fatima Jalloh allows following entities to bill medicare on her behalf.
Entity Name | Adapt |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1720010549 PECOS PAC ID: 4587662887 Enrollment ID: O20061121000327 |
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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. Fatima Jalloh 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 |
Fatima Jalloh, Po Box 1121, Roseburg, OR 97470-0254 Ph: (541) 440-3532 | Fatima Jalloh, 3005 Ne Diamond Lake Blvd, Roseburg, OR 97470-3609 Ph: (541) 440-3532 |
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