Dr Jeffrey Standage, DMD is a medicare enrolled "Dentist" provider in Peridot, Arizona. His current practice location is
104 Medicine Way, Peridot, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 475-1480.
Dr Jeffrey Standage is licensed to practice in Arizona (license number D009457) 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 1093167041.
Healthcare Provider's Profile
Full Name | Dr Jeffrey Standage |
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Gender | Male |
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Speciality | Dentist |
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Location | 104 Medicine Way, Peridot, Arizona |
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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: 1093167041
- Provider Enumeration Date: 07/01/2016
- Last Update Date: 10/21/2016
Medicare PECOS Information:
- PECOS PAC ID: 5496037855
- Enrollment ID: I20170410002337
Medical Identifiers
Medical identifiers for Dr Jeffrey Standage such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1093167041 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | D009457 (Arizona) | 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. Dr Jeffrey Standage allows following entities to bill medicare on his behalf.
Entity Name | San Carlos Apache Healthcare Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1265813075 PECOS PAC ID: 0648580597 Enrollment ID: O20151105002091 |
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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. Dr Jeffrey Standage 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 |
Dr Jeffrey Standage, DMD 104 Medicine Way, Peridot, AZ 85542-0000 Ph: (928) 475-1480 | Dr Jeffrey Standage, DMD 104 Medicine Way, Peridot, AZ 85542-0000 Ph: (928) 475-1480 |
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