Mr Jack Hurd Clendenin, NURSE PRACTITIONER - Medicare Nurse Practitioner in Gustine, CA

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Mr Jack Hurd Clendenin, NURSE PRACTITIONER is a medicare enrolled "Nurse Practitioner - Family" in Gustine, California. His current practice location is 581 4th Ave, Gustine, California. You can reach out to his office (for appointments etc.) via phone at (209) 854-1120.

Mr Jack Hurd Clendenin is licensed to practice in California (license number 351888 NP8015) 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 1124210513.

Contact Information

Mr Jack Hurd Clendenin, NURSE PRACTITIONER
581 4th Ave,
Gustine, CA 95322-1143
(209) 854-1120
(209) 854-1118

Map and Direction




Provider's Profile

Full NameMr Jack Hurd Clendenin
GenderMale
SpecialityNurse Practitioner - Family
Location581 4th Ave, Gustine, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124210513
  • Provider Enumeration Date: 08/09/2007
  • Last Update Date: 08/09/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 3173563616
  • Enrollment ID: I20050504000790

Medical Identifiers

Medical identifiers for Mr Jack Hurd Clendenin such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124210513NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 351888 NP8015 (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. Mr Jack Hurd Clendenin allows following entities to bill medicare on his behalf.
Entity NamePattabiraman B Iyer
Entity TypePractitioner - Family Practice
Entity IdentifiersNPI Number: 1083616817
PECOS PAC ID: 7719059773
Enrollment ID: I20080708000395

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. Mr Jack Hurd Clendenin 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 AddressPractice Location Address
Mr Jack Hurd Clendenin, NURSE PRACTITIONER
581 4th Ave,
Gustine, CA 95322-1143

Ph: (209) 854-1120		Mr Jack Hurd Clendenin, NURSE PRACTITIONER
581 4th Ave,
Gustine, CA 95322-1143

Ph: (209) 854-1120

Reviews and Comments


Nurse Practitioner Nurses in Gustine, CA

Mrs. Lisa Brush, NP
Nurse Practitioner
Medicare: Medicare Enrolled
Practice Location: 489 5th St, Gustine, CA 95322
Phone: 209-854-3728    
Sandra J. Haar, F.N.P
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 554 5th St, Gustine, CA 95322
Phone: 209-854-3854    Fax: 209-854-6758
Manmeet Johal, FNP
Nurse Practitioner
Medicare: Accepting Medicare Assignments
Practice Location: 489 5th St, Gustine, CA 95322
Phone: 209-854-3728    
Saudia Fatima Whitaker, AGNP-C
Nurse Practitioner
Medicare: Not Enrolled in Medicare
Practice Location: 489 5th St, Gustine, CA 95322
Phone: 209-854-3728    

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.