Jerry Clifton Ivy, PT is a medicare enrolled "Physical Therapist" provider in Joseph, Oregon. His current practice location is
4 S Main St Ste B, Joseph, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 432-1480.
Jerry Clifton Ivy is licensed to practice in Oregon (license number 2125) 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 1093778680.
Healthcare Provider's Profile
| Full Name | Jerry Clifton Ivy |
|---|
| Gender | Male |
|---|
| Speciality | Physical Therapist |
|---|
| Location | 4 S Main St Ste B, Joseph, Oregon |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1093778680
- Provider Enumeration Date: 04/06/2006
- Last Update Date: 01/16/2020
Medicare PECOS Information:
- PECOS PAC ID: 7810928421
- Enrollment ID: I20050823001162
Medical Identifiers
Medical identifiers for Jerry Clifton Ivy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093778680 | NPI | - | NPPES |
| 016852 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 225100000X | Physical Therapist | 2125 (Oregon) | 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. Jerry Clifton Ivy allows following entities to bill medicare on his behalf.
| Provider Name | Winding Waters Medical Clinic |
|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
|---|
| Provider Identifiers | NPI Number: 1922475219
PECOS PAC ID: 8224346713
Enrollment ID: O20160113000362 |
|---|
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. Jerry Clifton Ivy 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 |
|---|
Jerry Clifton Ivy, PT
Po Box 355,
Enterprise, OR 97828-0355
Ph: (541) 426-4870 | Jerry Clifton Ivy, PT
4 S Main St Ste B,
Joseph, OR 97846-8434
Ph: (541) 432-1480 |
Reviews and Comments