Alie Riad Jreisat, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Kingman, Arizona. His current practice location is
2202 N Stockton Hill Rd Ste 101, Kingman, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 757-2101.
Alie Riad Jreisat is licensed to practice in * (Not Available) (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 1578130555.
Physician's Profile
| Full Name | Alie Riad Jreisat |
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| Gender | Male |
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| Speciality | Student In An Organized Health Care Education/training Program |
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| Location | 2202 N Stockton Hill Rd Ste 101, Kingman, 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: 1578130555
- Provider Enumeration Date: 06/08/2021
- Last Update Date: 06/22/2021
Medicare PECOS Information:
- PECOS PAC ID: 5496295685
- Enrollment ID: I20240914000561
Medical Identifiers
Medical identifiers for Alie Riad Jreisat such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1578130555 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 207Q00000X | Family Medicine | R78878 (Arizona) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | 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. Alie Riad Jreisat allows following entities to bill medicare on his behalf.
| Entity Name | Lakeside Heart And Vascular Center Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801194352 PECOS PAC ID: 4587832779 Enrollment ID: O20110713000658 |
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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. Alie Riad Jreisat 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 |
Alie Riad Jreisat, MD 734 Country Club Dr, Kingman, AZ 86401-3971 Ph: (708) 466-2700 | Alie Riad Jreisat, MD 2202 N Stockton Hill Rd Ste 101, Kingman, AZ 86401-4622 Ph: (928) 757-2101 |
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