Dr Jacqueline Maria Fennerty, DPM is a medicare enrolled "Podiatrist" provider in Elmira, Oregon. Her current practice location is
25121 Tripp Rd, Elmira, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 521-9387.
Dr Jacqueline Maria Fennerty is licensed to practice in Oregon (license number DP00292) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1992871495.
Healthcare Provider's Profile
| Full Name | Dr Jacqueline Maria Fennerty |
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| Gender | Female |
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| Speciality | Podiatrist |
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| Location | 25121 Tripp Rd, Elmira, Oregon |
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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: 1992871495
- Provider Enumeration Date: 11/27/2006
- Last Update Date: 01/12/2023
Medicare PECOS Information:
- PECOS PAC ID: 1254435076
- Enrollment ID: I20070403000383
Medical Identifiers
Medical identifiers for Dr Jacqueline Maria Fennerty such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992871495 | NPI | - | NPPES |
| 150584 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213E00000X | Podiatrist | DP00292 (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. Dr Jacqueline Maria Fennerty allows following entities to bill medicare on her behalf.
| Provider Name | Ppc Group Llc |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1508190661
PECOS PAC ID: 4789723115
Enrollment ID: O20091125000080 |
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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. Dr Jacqueline Maria Fennerty 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 |
|---|
Dr Jacqueline Maria Fennerty, DPM
25121 Tripp Rd,
Elmira, OR 97437-9612
Ph: (415) 219-3875 | Dr Jacqueline Maria Fennerty, DPM
25121 Tripp Rd,
Elmira, OR 97437-9612
Ph: (541) 521-9387 |
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