Dr Benjamin Jacob Colburn, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Clackamas, Oregon. His current practice location is
10100 Se Sunnyside Rd, Clackamas, Oregon. You can reach out to his office (for appointments etc.) via phone at
(503) 494-8211.
Dr Benjamin Jacob Colburn 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 1104357714.
Physician's Profile
Full Name | Dr Benjamin Jacob Colburn |
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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 | 10100 Se Sunnyside Rd, Clackamas, 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: 1104357714
- Provider Enumeration Date: 03/24/2017
- Last Update Date: 09/02/2021
Medicare PECOS Information:
- PECOS PAC ID: 6103182621
- Enrollment ID: I20221130000370
Medical Identifiers
Medical identifiers for Dr Benjamin Jacob Colburn such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1104357714 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | MD61204134 (Washington) | Secondary |
207Q00000X | Family Medicine | MD191309 (Oregon) | 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. Dr Benjamin Jacob Colburn allows following entities to bill medicare on his behalf.
Entity Name | Kaiser Foundation Health Plan Of The Northwest |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1184786527 PECOS PAC ID: 5799688230 Enrollment ID: O20040220000099 |
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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 Benjamin Jacob Colburn 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 Benjamin Jacob Colburn, MD 500 Ne Multnomah St Ste 100, Portland, OR 97232-2031 Ph: (503) 494-8211 | Dr Benjamin Jacob Colburn, MD 10100 Se Sunnyside Rd, Clackamas, OR 97015-8970 Ph: (503) 494-8211 |
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