Sara Juanita Jumping Eagle, MD is a medicare enrolled "Pediatrics - Adolescent Medicine" physician in Ft. Yates, North Dakota. Her current practice location is
10 N. River Rd., Fort Yates Ihs Hospital/clinic, Ft. Yates, North Dakota. You can reach out to her office (for appointments etc.) via phone at
(701) 854-3831.
Sara Juanita Jumping Eagle is licensed to practice in North Dakota (license number 11019) 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 1508865007.
Physician's Profile
Full Name | Sara Juanita Jumping Eagle |
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Gender | Female |
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Speciality | Pediatrics - Adolescent Medicine |
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Location | 10 N. River Rd., Ft. Yates, North Dakota |
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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: 1508865007
- Provider Enumeration Date: 07/18/2005
- Last Update Date: 12/03/2014
Medicare PECOS Information:
- PECOS PAC ID: 7113950049
- Enrollment ID: I20160531001602
Medical Identifiers
Medical identifiers for Sara Juanita Jumping Eagle such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1508865007 | NPI | - | NPPES |
15044 | Medicaid | ND | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
2080A0000X | Pediatrics - Adolescent Medicine | 11019 (North Dakota) | 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. Sara Juanita Jumping Eagle allows following entities to bill medicare on her behalf.
Entity Name | Pine Ridge Indian Health Service Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1497786412 PECOS PAC ID: 4688571326 Enrollment ID: O20031218000966 |
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Entity Name | Pine Ridge Indian Health Service Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1003963497 PECOS PAC ID: 7214825371 Enrollment ID: O20040309001203 |
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Entity Name | Fort Yates Indian Health Service Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1609851039 PECOS PAC ID: 3678462744 Enrollment ID: O20040315001479 |
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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. Sara Juanita Jumping Eagle 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 |
Sara Juanita Jumping Eagle, MD 10 North River Road, Fort Yates, ND 58538 Ph: (701) 854-3831 | Sara Juanita Jumping Eagle, MD 10 N. River Rd., Fort Yates Ihs Hospital/clinic, Ft. Yates, ND 58538 Ph: (701) 854-3831 |
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