Dr Jimmie R Charlie, MD in Santo Domingo, NM

Dr Jimmie R Charlie, MD is a medicare enrolled "Family Medicine" physician in Santo Domingo, New Mexico. He went to Stanford University School Of Medicine and graduated in 1998 and has 26 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Kewa Pueblo Health Corporation and his current practice location is 85 West Highway 22, Santo Domingo, New Mexico. You can reach out to his office (for appointments etc.) via phone at (505) 465-3060.

Dr Jimmie R Charlie is licensed to practice in New Mexico (license number 20020019) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1366523722.

Contact Information

	Dr Jimmie R Charlie, MD
	85 West Highway 22, Santo Domingo, NM 87502-0340
	(505) 465-3060
	(505) 465-3060

Map and Direction

Physician's Profile

Full Name	Dr Jimmie R Charlie
Gender	Male
Speciality	Family Practice
Experience	26 Years
Location	85 West Highway 22, Santo Domingo, New Mexico
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Dr Jimmie R Charlie attended and graduated from Stanford University School Of Medicine in 1998

NPI Data:

NPI Number: 1366523722
Provider Enumeration Date: 10/18/2006
Last Update Date: 09/02/2016

Medicare PECOS Information:

PECOS PAC ID: 7911047543
Enrollment ID: I20091211000706

Medical Identifiers

Medical identifiers for Dr Jimmie R Charlie such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366523722	NPI	-	NPPES
85534862	Medicaid	NM

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	20020019 (New Mexico)	Primary

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Kewa Pueblo Health Corporation	7618137779	21

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 Jimmie R Charlie allows following entities to bill medicare on his behalf.

Entity Name	Kewa Pueblo Health Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1467739888 PECOS PAC ID: 7618137779 Enrollment ID: O20120327000617

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 Jimmie R Charlie 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 Jimmie R Charlie, MD Po Box 340, Santo Domingo Pueblo, NM 87052-0340 Ph: (505) 465-3060	Dr Jimmie R Charlie, MD 85 West Highway 22, Santo Domingo, NM 87502-0340 Ph: (505) 465-3060

Dr Jimmie R Charlie, MD - Medicare Family Practice in Santo Domingo, NM