Mrs Doreen Onipede Jackson, MD is a medicare enrolled "Colon & Rectal Surgery" physician in Travis Air Force Base, California. Her current practice location is
101 Bodin Circle, Travis Air Force Base, California. You can reach out to her office (for appointments etc.) via phone at
(919) 753-6879.
Mrs Doreen Onipede Jackson is licensed to practice in California (license number 171636) 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 1649615287.
Physician's Profile
Full Name | Mrs Doreen Onipede Jackson |
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Gender | Female |
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Speciality | Colon & Rectal Surgery |
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Location | 101 Bodin Circle, Travis Air Force Base, California |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1649615287
- Provider Enumeration Date: 05/09/2013
- Last Update Date: 08/19/2022
Medicare PECOS Information:
- PECOS PAC ID: 0042625279
- Enrollment ID: I20210310002152
Medical Identifiers
Medical identifiers for Mrs Doreen Onipede Jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1649615287 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208600000X | Surgery | 171636 (California) | Secondary |
208C00000X | Colon & Rectal Surgery | ME139661 (Florida) | Secondary |
208D00000X | General Practice | 204413 (North Carolina) | Secondary |
208C00000X | Colon & Rectal Surgery | 171636 (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. Mrs Doreen Onipede Jackson allows following entities to bill medicare on her behalf.
Entity Name | Regents Of The Univ Of Ca |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1013906973 PECOS PAC ID: 3375456619 Enrollment ID: O20031111000892 |
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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. Mrs Doreen Onipede 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 |
Mrs Doreen Onipede Jackson, MD 101 Bodin Circle, David Grant Medical Center - Travis Air Force Base, Fairfield, CA 94535 Ph: (919) 753-6879 | Mrs Doreen Onipede Jackson, MD 101 Bodin Circle, Travis Air Force Base, CA 94535-1800 Ph: (919) 753-6879 |
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