Dr Richard Polson Mcclintock Jr, MD is a medicare enrolled "Dermatology" physician in Ukiah, California. His current practice location is
723 S Dora St, Ukiah, California. You can reach out to his office (for appointments etc.) via phone at
(707) 462-1401.
Dr Richard Polson Mcclintock Jr is licensed to practice in California (license number G-9547) 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 1124016712.
Physician's Profile
Full Name | Dr Richard Polson Mcclintock Jr |
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Gender | Male |
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Speciality | Dermatology |
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Location | 723 S Dora St, Ukiah, 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: 1124016712
- Provider Enumeration Date: 10/09/2005
- Last Update Date: 11/17/2008
Medicare PECOS Information:
- PECOS PAC ID: 5193791846
- Enrollment ID: I20040903000832
Medical Identifiers
Medical identifiers for Dr Richard Polson Mcclintock Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1124016712 | NPI | - | NPPES |
05D061485 | Other | | CLIA |
072727935 | Other | | RAILROAD MEDICARE |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207N00000X | Dermatology | G-9547 (California) | Primary |
207ND0900X | Dermatology - Dermatopathology | G-9547 (California) | 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 Richard Polson Mcclintock Jr allows following entities to bill medicare on his behalf.
Entity Name | Mendocino Community Health Clinic Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497961106 PECOS PAC ID: 6305755455 Enrollment ID: O20040826001483 |
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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 Richard Polson Mcclintock Jr 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 Richard Polson Mcclintock Jr, MD 723 S Dora St, Ukiah, CA 95482-5335 Ph: (707) 462-1401 | Dr Richard Polson Mcclintock Jr, MD 723 S Dora St, Ukiah, CA 95482-5335 Ph: (707) 462-1401 |
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