Dr Jerry Russell Bartleson, MD is a medicare enrolled "Emergency Medicine" physician in Tully, New York. His current practice location is
7434 Song Lake Rd, Tully, New York. You can reach out to his office (for appointments etc.) via phone at
(315) 696-5539.
Dr Jerry Russell Bartleson is licensed to practice in New York (license number 163749) 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 1386686376.
Physician's Profile
| Full Name | Dr Jerry Russell Bartleson |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 7434 Song Lake Rd, Tully, New York |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1386686376
- Provider Enumeration Date: 06/12/2006
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 0042102667
- Enrollment ID: I20040329000277
Medical Identifiers
Medical identifiers for Dr Jerry Russell Bartleson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1386686376 | NPI | - | NPPES |
| 31522700 | Medicaid | WI | |
| 163749 | Medicaid | NY | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | 163749 (New York) | Primary |
| 207P00000X | Emergency Medicine | 31435 (Minnesota) | Secondary |
| 207P00000X | Emergency Medicine | 28860 (Wisconsin) | Secondary |
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 Jerry Russell Bartleson allows following entities to bill medicare on his behalf.
| Entity Name | Michael Pm Pond |
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| Entity Type | Practitioner - Emergency Medicine |
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| Entity Identifiers | NPI Number: 1962472514
PECOS PAC ID: 6709854367
Enrollment ID: I20040921001002 |
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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 Jerry Russell Bartleson 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 Jerry Russell Bartleson, MD
7434 Song Lake Rd,
Tully, NY 13159-9211
Ph: (315) 696-5539 | Dr Jerry Russell Bartleson, MD
7434 Song Lake Rd,
Tully, NY 13159-9211
Ph: (315) 696-5539 |
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