Dr Bennet Ifeakandu Omalu, MD, MBA, MPH is a medicare enrolled "Independent Medical Examiner" physician in Sacramento, California. His current practice location is
4400 V Street, University Of California, Davis, Medical Center, Sacramento, California. You can reach out to his office (for appointments etc.) via phone at
(916) 734-2525.
Dr Bennet Ifeakandu Omalu is licensed to practice in California (license number C52868) 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 1346467370.
Physician's Profile
Full Name | Dr Bennet Ifeakandu Omalu |
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Gender | Male |
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Speciality | Independent Medical Examiner |
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Location | 4400 V Street, Sacramento, California |
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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: 1346467370
- Provider Enumeration Date: 04/19/2007
- Last Update Date: 03/23/2020
Medicare PECOS Information:
- PECOS PAC ID: 8628237203
- Enrollment ID: I20120319000264
Medical Identifiers
Medical identifiers for Dr Bennet Ifeakandu Omalu such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1346467370 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ZC0006X | Pathology - Clinical Pathology | C52868 (California) | Secondary |
207ZF0201X | Pathology - Forensic Pathology | C52868 (California) | Secondary |
207ZN0500X | Pathology - Neuropathology | C52868 (California) | Secondary |
207ZP0101X | Pathology - Anatomic Pathology | C52868 (California) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | C52868 (California) | Secondary |
209800000X | Legal Medicine | C52868 (California) | Secondary |
202C00000X | Independent Medical Examiner | C52868 (California) | 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 Bennet Ifeakandu Omalu allows following entities to bill medicare on his behalf.
Entity Name | Regents Of The Univ Of Ca |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013906973 PECOS PAC ID: 3375456619 Enrollment ID: O20031111000892 |
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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 Bennet Ifeakandu Omalu 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 Bennet Ifeakandu Omalu, MD, MBA, MPH 3031 W March Ln Ste 323, Stockton, CA 95219-6578 Ph: (092) 636-2822 | Dr Bennet Ifeakandu Omalu, MD, MBA, MPH 4400 V Street, University Of California, Davis, Medical Center, Sacramento, CA 95817 Ph: (916) 734-2525 |
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