Jason S Hallock, PA-C is a medicare enrolled "Physician Assistant" physician in Chattanooga, Tennessee. His current practice location is
2525 Desales Avenue, Chattanooga, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(423) 697-0014.
Jason S Hallock is licensed to practice in Tennessee (license number PA1317) 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 1710922950.
Physician's Profile
| Full Name | Jason S Hallock |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 2525 Desales Avenue, Chattanooga, Tennessee |
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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: 1710922950
- Provider Enumeration Date: 06/19/2006
- Last Update Date: 02/12/2021
Medicare PECOS Information:
- PECOS PAC ID: 4183630031
- Enrollment ID: I20060301000471
Medical Identifiers
Medical identifiers for Jason S Hallock such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1710922950 | NPI | - | NPPES |
| 257502672A | Medicaid | GA | |
| 3370172 | Other | TN | MEDICARE PTAN |
| 3664283 | Other | TN | MEDICARE PTAN |
| 3726561 | Other | TN | MEDICARE PTAN |
| 36642831 | Other | TN | MEDICARE PTAN |
| 4116090 | Other | TN | BCBS OF TENNESSEE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | PA1317 (Tennessee) | Secondary |
| 363A00000X | Physician Assistant | PA1317 (Tennessee) | 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. Jason S Hallock allows following entities to bill medicare on his behalf.
| Entity Name | Physicians Care Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1437194222
PECOS PAC ID: 8426962135
Enrollment ID: O20040109000360 |
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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. Jason S Hallock 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 |
|---|
Jason S Hallock, PA-C
725 Glenwood Drive,, Suite E-487,
Chattanooga, TN 37404
Ph: (423) 697-0014 | Jason S Hallock, PA-C
2525 Desales Avenue,
Chattanooga, TN 37404
Ph: (423) 697-0014 |
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