Kenneth H. Ballentine Od Inc. is a medicare enrolled "Eyewear Supplier" provider in San Jose, California. Their current practice location is
5275 Prospect Rd, San Jose, California. You can reach out to their office (for appointments etc.) via phone at
(408) 255-0576.
Kenneth H. Ballentine Od Inc. is licensed to practice in California (license number 6863T) and it also participates in the medicare program. Kenneth H. Ballentine Od Inc.
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1649448507.
Healthcare Provider's Profile
| Full Name | Kenneth H. Ballentine Od Inc. |
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| Type | Facility |
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| Speciality | Eyewear Supplier |
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| Location | 5275 Prospect Rd, San Jose, California |
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| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1649448507
- Provider Enumeration Date: 02/13/2008
- Last Update Date: 09/06/2012
Medicare PECOS Information:
- PECOS PAC ID: 1557544160
- Enrollment ID: O20120130000576
Medical Identifiers
Medical identifiers for Kenneth H. Ballentine Od Inc. such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649448507 | NPI | - | NPPES |
| SD0068630 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | 6863T (California) | Secondary |
| 332H00000X | Eyewear Supplier | 6863T (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.
Kenneth H. Ballentine Od Inc. acts as a billing entity for following providers:
| Provider Name | Kenneth Ballentine |
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| Provider Type | Practitioner - Optometry |
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| Provider Identifiers | NPI Number: 1548230071
PECOS PAC ID: 7416130026
Enrollment ID: I20120130000723 |
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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. Kenneth H. Ballentine Od Inc. 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 |
|---|
Kenneth H. Ballentine Od Inc.
5275 Prospect Rd,
San Jose, CA 95129-5031
Ph: (408) 255-0576 | Kenneth H. Ballentine Od Inc.
5275 Prospect Rd,
San Jose, CA 95129-5031
Ph: (408) 255-0576 |
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