Mr Jordan Michael Holt, CAA is a medicare enrolled "Anesthesiology" in Muncie, Indiana. His current practice location is
2401 W University Ave, Muncie, Indiana. You can reach out to his office (for appointments etc.) via phone at
(765) 751-2649.
Mr Jordan Michael Holt is licensed to practice in Indiana (license number 75000113A) 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 1699232736.
Provider's Profile
| Full Name | Mr Jordan Michael Holt |
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| Gender | Male |
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| Speciality | Anesthesiology |
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| Location | 2401 W University Ave, Muncie, Indiana |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1699232736
- Provider Enumeration Date: 02/25/2019
- Last Update Date: 09/27/2022
Medicare PECOS Information:
- PECOS PAC ID: 6507288420
- Enrollment ID: I20221114002583
Medical Identifiers
Medical identifiers for Mr Jordan Michael Holt such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1699232736 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367H00000X | Anesthesiologist Assistant | 26 (Oklahoma) | Secondary |
| 207L00000X | Anesthesiology | 75000113A (Indiana) | 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 Jordan Michael Holt allows following entities to bill medicare on his behalf.
| Entity Name | Indiana University Health Ball Memorial Physicians Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1235455544
PECOS PAC ID: 9537072640
Enrollment ID: O20031110000505 |
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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. Mr Jordan Michael Holt 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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Mr Jordan Michael Holt, CAA
250 N Shadeland Ave,
Indianapolis, IN 46219-4959
Ph: () - | Mr Jordan Michael Holt, CAA
2401 W University Ave,
Muncie, IN 47303-3428
Ph: (765) 751-2649 |
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