Dr John Mark Bouchillon, MD is a medicare enrolled "Pediatrics" physician in Peterson Afb, Colorado. His current practice location is
559 Vincent St, Attn: 21 Hcos/sgoc - Pediatrics, Peterson Afb, Colorado. You can reach out to his office (for appointments etc.) via phone at
(719) 556-1197.
Dr John Mark Bouchillon is licensed to practice in Alabama (license number MD.35462) 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 1386030476.
Physician's Profile
| Full Name | Dr John Mark Bouchillon |
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| Gender | Male |
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| Speciality | Pediatrics |
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| Location | 559 Vincent St, Peterson Afb, Colorado |
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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: 1386030476
- Provider Enumeration Date: 04/15/2015
- Last Update Date: 09/12/2019
Medicare PECOS Information:
- PECOS PAC ID: 2668780602
- Enrollment ID: I20180814001463
Medical Identifiers
Medical identifiers for Dr John Mark Bouchillon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1386030476 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208000000X | Pediatrics | MD.35462 (Alabama) | 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 John Mark Bouchillon allows following entities to bill medicare on his behalf.
| Entity Name | University Of Alabama Health Services Foundation, Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1093768723
PECOS PAC ID: 1951213107
Enrollment ID: O20031105000261 |
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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 John Mark Bouchillon 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 |
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Dr John Mark Bouchillon, MD
559 Vincent St, Attn: 21 Hcos/sgoc - Pediatrics,
Peterson Afb, CO 80914-1540
Ph: (719) 556-1197 | Dr John Mark Bouchillon, MD
559 Vincent St, Attn: 21 Hcos/sgoc - Pediatrics,
Peterson Afb, CO 80914-1540
Ph: (719) 556-1197 |
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