Jeffrey D Richardson, PT is a medicare enrolled "Physical Therapist" provider in San Carlos, Arizona. His current practice location is
223 Cibeque Circle Road, San Carlos, Arizona. You can reach out to his office (for appointments etc.) via phone at
(928) 475-7219.
Jeffrey D Richardson is licensed to practice in Arizona (license number 5040 PT) 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 1356453278.
Healthcare Provider's Profile
| Full Name | Jeffrey D Richardson |
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| Gender | Male |
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| Speciality | Physical Therapist |
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| Location | 223 Cibeque Circle Road, San Carlos, Arizona |
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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: 1356453278
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 07/09/2007
Medicare PECOS Information:
- PECOS PAC ID: 4688776933
- Enrollment ID: I20070216000542
Medical Identifiers
Medical identifiers for Jeffrey D Richardson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1356453278 | NPI | - | NPPES |
| 482729 | Medicaid | AZ | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 5040 PT (Arizona) | 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. Jeffrey D Richardson allows following entities to bill medicare on his behalf.
| Provider Name | San Carlos Apache Healthcare Corporation |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1265813075
PECOS PAC ID: 0648580597
Enrollment ID: O20151105002091 |
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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. Jeffrey D Richardson 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 |
|---|
Jeffrey D Richardson, PT
Po Box 208,
San Carlos, AZ 85550-0208
Ph: (928) 475-7219 | Jeffrey D Richardson, PT
223 Cibeque Circle Road,
San Carlos, AZ 85550-0208
Ph: (928) 475-7219 |
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