Jacy A Stauffer, DMD in Portland, OR - Medicare Dentist Provider

Jacy A Stauffer, DMD is a medicare enrolled "Dentist - Pediatric Dentistry" provider in Portland, Oregon. Her current practice location is 3181 Sw Sam Jackson Park Rd, Portland, Oregon. You can reach out to her office (for appointments etc.) via phone at (503) 418-5799.

Jacy A Stauffer is licensed to practice in Oregon (license number DF0053) 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 1699974014.

Contact Information

	Jacy A Stauffer, DMD
	3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011
	(503) 418-5799
	(503) 418-4750

Map and Direction

Healthcare Provider's Profile

Full Name	Jacy A Stauffer
Gender	Female
Speciality	Dentist - Pediatric Dentistry
Location	3181 Sw Sam Jackson Park Rd, Portland, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1699974014
Provider Enumeration Date: 07/16/2007
Last Update Date: 11/10/2022

Medicare PECOS Information:

PECOS PAC ID: 1658672613
Enrollment ID: I20221014002228

Medical Identifiers

Medical identifiers for Jacy A Stauffer such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1699974014	NPI	-	NPPES
119591300	Medicaid	MD

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223P0221X	Dentist - Pediatric Dentistry	LL738 (Maryland)	Secondary
1223P0221X	Dentist - Pediatric Dentistry	DF0053 (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. Jacy A Stauffer allows following entities to bill medicare on her behalf.

Entity Name	University Professional Services
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376709535 PECOS PAC ID: 4880760107 Enrollment ID: O20080910000013

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. Jacy A Stauffer 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
Jacy A Stauffer, DMD 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 Ph: (503) 418-5799	Jacy A Stauffer, DMD 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 Ph: (503) 418-5799

Reviews and Comments

Dentist in Portland, OR

Esther Jihae Lee, Dentist Medicare: Not Enrolled in Medicare Practice Location: 5308 Se 52nd Ave, Portland, OR 97206 Phone: 503-775-4000
Dr. Elizabeth Freda Schuler, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 202 Ne 181st Ave Ste C, Portland, OR 97230 Phone: 503-912-0443
Dr. Octavia S Lively, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 3710 Sw Us Vetrn Hosp Rd, Portland, OR 97239 Phone: 503-220-8262
Michelle R Lawrence, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 3671 Sw River Pkwy, Portland, OR 97239 Phone: 503-841-5658 Fax: 503-384-2953
Albert Vinh Khiem Ngo, Dentist Medicare: Medicare Enrolled Practice Location: 4104 Se 82nd Ave Ste 450, Portland, OR 97266 Phone: 562-852-3113
Dr. Esha Mukherjee, MSD Dentist Medicare: Not Enrolled in Medicare Practice Location: 2730 S Moody Ave, Portland, OR 97201 Phone: 502-531-3763
Dr. Larry Robert Franz, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 12135 Se Foster Rd, Portland, OR 97266 Phone: 503-760-7610 Fax: 503-760-7896

Jacy A Stauffer, DMD - Medicare Dentist in Portland, OR