Jordan Ray Ilse, MD is a medicare enrolled "Dermatology" physician in Belton, Texas. He went to Texas A & M University System, Hsc, College Of Medicine and graduated in 2007 and has 17 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Oliver Street 5.01(a) Inc and his current practice location is
1300 E. 6th Avenue, Belton, Texas. You can reach out to his office (for appointments etc.) via phone at
(254) 778-5400.
Jordan Ray Ilse is licensed to practice in Texas (license number N8307) 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 1477712479.
Physician's Profile
| Full Name | Jordan Ray Ilse |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 17 Years |
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| Location | 1300 E. 6th Avenue, Belton, Texas |
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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:
- Jordan Ray Ilse attended and graduated from Texas A & M University System, Hsc, College Of Medicine in 2007
NPI Data:
- NPI Number: 1477712479
- Provider Enumeration Date: 06/04/2008
- Last Update Date: 08/04/2017
Medicare PECOS Information:
- PECOS PAC ID: 9032380431
- Enrollment ID: I20110915000168
Medical Identifiers
Medical identifiers for Jordan Ray Ilse such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1477712479 | NPI | - | NPPES |
| N8307 | Other | TX | TX LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | N8307 (Texas) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Oliver Street 5.01(a) Inc | 0042464125 | 144 |
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 Ray Ilse allows following entities to bill medicare on his behalf.
| Entity Name | Oliver Street 5.01(a) Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457695413
PECOS PAC ID: 0042464125
Enrollment ID: O20130128000189 |
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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. Jordan Ray Ilse 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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Jordan Ray Ilse, MD
1300 East 6th Ave,
Belton, TX 76513
Ph: (254) 778-5400 | Jordan Ray Ilse, MD
1300 E. 6th Avenue,
Belton, TX 76513-2810
Ph: (254) 778-5400 |
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