Dr Jimmy G Bozeman, MD is a medicare enrolled "General Practice" physician in Salem, Arkansas. His current practice location is
507 N Main St, Salem, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(870) 895-2541.
Dr Jimmy G Bozeman is licensed to practice in Arkansas (license number C-4579) 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 1164499935.
Physician's Profile
| Full Name | Dr Jimmy G Bozeman |
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| Gender | Male |
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| Speciality | General Practice |
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| Location | 507 N Main St, Salem, Arkansas |
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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: 1164499935
- Provider Enumeration Date: 03/01/2006
- Last Update Date: 02/01/2017
Medicare PECOS Information:
- PECOS PAC ID: 0648328302
- Enrollment ID: I20090916000145
Medical Identifiers
Medical identifiers for Dr Jimmy G Bozeman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164499935 | NPI | - | NPPES |
| 200621605 | Other | MO | MEDICAID |
| 50573 | Other | AR | BLUE CROSS BLUE SHIELD |
| 102258001 | Medicaid | AR | |
| 127770000 | Other | AR | QUALCHOICE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208D00000X | General Practice | C-4579 (Arkansas) | 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 Jimmy G Bozeman allows following entities to bill medicare on his behalf.
| Entity Name | Fulton County Hospital |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831274612
PECOS PAC ID: 8921099961
Enrollment ID: O20060127000010 |
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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 Jimmy G Bozeman 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 Jimmy G Bozeman, MD
Po Box 517,
Salem, AR 72576-0517
Ph: (870) 895-6096 | Dr Jimmy G Bozeman, MD
507 N Main St,
Salem, AR 72576-9449
Ph: (870) 895-2541 |
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