Eliceia Dionne Jackson, MD is a medicare enrolled "Family Medicine" physician in Irvington, Alabama. Her current practice location is
12701 Padgett Switch Rd, Irvington, Alabama. You can reach out to her office (for appointments etc.) via phone at
(251) 824-2174.
Eliceia Dionne Jackson is licensed to practice in Alabama (license number 46088) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1699937557.
Physician's Profile
Full Name | Eliceia Dionne Jackson |
---|
Gender | Female |
---|
Speciality | Family Medicine |
---|
Location | 12701 Padgett Switch Rd, Irvington, Alabama |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1699937557
- Provider Enumeration Date: 07/01/2008
- Last Update Date: 03/31/2023
Medicare PECOS Information:
- PECOS PAC ID: 3870763279
- Enrollment ID: I20230413001551
Medical Identifiers
Medical identifiers for Eliceia Dionne Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1699937557 | NPI | - | NPPES |
09180751 | Medicaid | MS | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207Q00000X | Family Medicine | 21663 (Mississippi) | Secondary |
207Q00000X | Family Medicine | 46088 (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. Eliceia Dionne Jackson allows following entities to bill medicare on her behalf.
Entity Name | Bayou La Batre Area Health Development Board, Inc. |
---|
Entity Type | Part B Supplier - Clinic/group Practice |
---|
Entity Identifiers | NPI Number: 1396794426 PECOS PAC ID: 3577472810 Enrollment ID: O20040510000323 |
---|
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. Eliceia Dionne Jackson 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 |
Eliceia Dionne Jackson, MD 12701 Padgett Switch Rd, Irvington, AL 36544-4011 Ph: (251) 824-2174 | Eliceia Dionne Jackson, MD 12701 Padgett Switch Rd, Irvington, AL 36544-4011 Ph: (251) 824-2174 |
Reviews and Comments