Mr Jack Lee Otterstrom, LCSW - Medicare Counselor in Independence, OR

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Mr Jack Lee Otterstrom, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Independence, Oregon. His current practice location is 656 Jasmine Cir, Independence, Oregon. You can reach out to his office (for appointments etc.) via phone at (541) 231-8023.

Mr Jack Lee Otterstrom is licensed to practice in Oregon (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1922163096.

Contact Information

Mr Jack Lee Otterstrom, LCSW
656 Jasmine Cir,
Independence, OR 97351-9578
(541) 231-8023
Not Available

Map and Direction


Healthcare Provider's Profile

Full NameMr Jack Lee Otterstrom
GenderMale
SpecialitySocial Worker - Clinical
Location656 Jasmine Cir, Independence, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1922163096
  • Provider Enumeration Date: 12/27/2006
  • Last Update Date: 09/06/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 5991801052
  • Enrollment ID: I20070507000154

Medical Identifiers

Medical identifiers for Mr Jack Lee Otterstrom such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1922163096NPI-NPPES
R145387MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
101YP2500XCounselor - Professional L5316 (Oregon)Secondary
1041C0700XSocial Worker - Clinical L3516 (Oregon)Secondary
1041C0700XSocial Worker - Clinical (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. Mr Jack Lee Otterstrom allows following entities to bill medicare on his behalf.
Entity NameSilverton Health
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1669424354
PECOS PAC ID: 8921901877
Enrollment ID: O20040129000172

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. Mr Jack Lee Otterstrom 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 AddressPractice Location Address
Mr Jack Lee Otterstrom, LCSW
619 Broad St S # 19,
Monmouth, OR 97361-2372

Ph: (412) 318-0235		Mr Jack Lee Otterstrom, LCSW
656 Jasmine Cir,
Independence, OR 97351-9578

Ph: (541) 231-8023

Reviews and Comments


Social Worker in Independence, OR


Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.