Mrs Jackie Dee Stafford, APRN is a medicare enrolled "Nurse Practitioner - Family" physician in Tulsa, Oklahoma. She graduated from medical school in 2010 and has 14 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Tbd Acquisition Ii Llc and her current practice location is
6161 S Yale Ave, Tulsa, Oklahoma. You can reach out to her office (for appointments etc.) via phone at
(918) 502-1900.
Mrs Jackie Dee Stafford is licensed to practice in Mississippi (license number 813602) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1568763019.
Physician's Profile
| Full Name | Mrs Jackie Dee Stafford |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 14 Years |
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| Location | 6161 S Yale Ave, Tulsa, Oklahoma |
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| Accepts Medicare Assignments | Yes. She 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:
- Mrs Jackie Dee Stafford graduated from medical school in 2010
NPI Data:
- NPI Number: 1568763019
- Provider Enumeration Date: 11/14/2010
- Last Update Date: 01/09/2024
Medicare PECOS Information:
- PECOS PAC ID: 5597949396
- Enrollment ID: I20110401000520
Medical Identifiers
Medical identifiers for Mrs Jackie Dee Stafford such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1568763019 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 111885 (Oklahoma) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 813602 (Mississippi) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Tbd Acquisition Ii Llc | 7911272257 | 8 |
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 Jackie Dee Stafford allows following entities to bill medicare on her behalf.
| Entity Name | Tbd Acquisition Ii Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1750891792
PECOS PAC ID: 7911272257
Enrollment ID: O20171219001761 |
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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 Jackie Dee Stafford 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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Mrs Jackie Dee Stafford, APRN
11150 Hwy 49,
Gulfport, MS 39503-3347
Ph: (228) 831-1700 | Mrs Jackie Dee Stafford, APRN
6161 S Yale Ave,
Tulsa, OK 74136-1902
Ph: (918) 502-1900 |
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