Jordan Blake Iceton, MD in Stanford, CA - Medicare Internal Medicine

Jordan Blake Iceton, MD is a medicare enrolled "Internal Medicine" physician in Stanford, California. His current practice location is 300 Pasteur Dr, Stanford, California. You can reach out to his office (for appointments etc.) via phone at (650) 723-4000.

Jordan Blake Iceton is licensed to practice in California (license number A195430) 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 1376129312.

Contact Information

	Jordan Blake Iceton, MD
	300 Pasteur Dr, Stanford, CA 94305-2200
	(650) 723-4000
	Not Available

Map and Direction

Physician's Profile

Full Name	Jordan Blake Iceton
Gender	Male
Speciality	Internal Medicine
Location	300 Pasteur Dr, Stanford, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1376129312
Provider Enumeration Date: 03/21/2021
Last Update Date: 10/23/2024

Medicare PECOS Information:

PECOS PAC ID: 3971736562
Enrollment ID: I20240518000301

Medical Identifiers

Medical identifiers for Jordan Blake Iceton such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1376129312	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	A195430 (California)	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. Jordan Blake Iceton allows following entities to bill medicare on his behalf.

Entity Name	Stanford Health Care
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1437292927 PECOS PAC ID: 6709797491 Enrollment ID: O20031124000348

Entity Name	Lpch Medical Group Div Of Lucile
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1417907940 PECOS PAC ID: 0840298543 Enrollment ID: O20061113000232

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. Jordan Blake Iceton 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
Jordan Blake Iceton, MD 300 Pasteur Dr, Stanford, CA 94305-2200 Ph: (650) 723-4000	Jordan Blake Iceton, MD 300 Pasteur Dr, Stanford, CA 94305-2200 Ph: (650) 723-4000

Reviews and Comments

Internal Medicine Doctors in Stanford, CA

Prista Charuworn, MD Internal Medicine Medicare: Not Enrolled in Medicare Practice Location: 300 Pasteur Dr, Alway Build M211, Mc 5187, Stanford, CA 94305 Phone: 650-723-6661
Yu Kuang Lai, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 Pasteur Dr, Stanford, CA 94305 Phone: 650-723-4000
Andrea Lorenze, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 Pasteur Drive, Lane 154, Stanford, CA 94305 Phone: 650-723-6661 Fax: 650-498-6205
Audra Horomanski, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 Pasteur Dr, Stanford, CA 94305 Phone: 650-723-4000 Fax: 650-498-6205
Meghan Brady Marmor, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 Pasteur Dr, Stanford, CA 94305 Phone: 650-723-4000
Lauren Michelle Ulsh, MD Internal Medicine Medicare: Medicare Enrolled Practice Location: 300 Pasteur Dr, Stanford, CA 94305 Phone: 650-723-4000
Ann M Chen, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 300 Pasteur Dr, A149, Mc5202, Stanford, CA 94305 Phone: 650-725-3376 Fax: 650-723-8305

Jordan Blake Iceton, MD - Medicare Internal Medicine in Stanford, CA