James Russell Keller Stackhouse, MD is a medicare enrolled "Ophthalmology" physician in Fernandina, Florida. He graduated from medical school in 2009 and has 15 years of diverse experience with area of expertise as Ophthalmology. He is a member of the group practice Russell Stackhouse Md Pa, Russell Stackhouse Md Pa and his current practice location is
6 S 14th St, Fernandina, Florida. You can reach out to his office (for appointments etc.) via phone at
(904) 261-5741.
James Russell Keller Stackhouse is licensed to practice in Florida (license number ME117902) 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 1750517710.
Physician's Profile
| Full Name | James Russell Keller Stackhouse |
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| Gender | Male |
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| Speciality | Ophthalmology |
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| Experience | 15 Years |
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| Location | 6 S 14th St, Fernandina, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- James Russell Keller Stackhouse graduated from medical school in 2009
NPI Data:
- NPI Number: 1750517710
- Provider Enumeration Date: 06/04/2009
- Last Update Date: 09/29/2021
Medicare PECOS Information:
- PECOS PAC ID: 1254572928
- Enrollment ID: I20140807001990
Medical Identifiers
Medical identifiers for James Russell Keller Stackhouse such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1750517710 | NPI | - | NPPES |
| 100661200 | Medicaid | FL | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207W00000X | Ophthalmology | 770778 (Georgia) | Secondary |
| 207W00000X | Ophthalmology | ME117902 (Florida) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Russell Stackhouse Md Pa | 9133473325 | 12 |
| Russell Stackhouse Md Pa | 9133473325 | 12 |
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. James Russell Keller Stackhouse allows following entities to bill medicare on his behalf.
| Entity Name | Russell Stackhouse Md Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1538655014
PECOS PAC ID: 9133473325
Enrollment ID: O20200122001607 |
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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. James Russell Keller Stackhouse 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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James Russell Keller Stackhouse, MD
6 S 14th St,
Fernandina Beach, FL 32034-3212
Ph: (904) 261-5741 | James Russell Keller Stackhouse, MD
6 S 14th St,
Fernandina, FL 32034
Ph: (904) 261-5741 |
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