| |
7371 Brandt Pike Ste D Huber Heights OH 45424-3276 | |
(937) 795-1101 | |
(937) 795-1120 |
Full Name | |
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Speciality | Family Medicine |
Location | 7371 Brandt Pike Ste D, Huber Heights, Ohio |
Authorized Official Name and Position | Jennifer Lynn Machuca (MD/ SOLO PHYSICIAN) |
Authorized Official Contact | 9377951101 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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7371 Brandt Pike Suite D Huber Heights OH 45424 Ph: (937) 795-1101 | 7371 Brandt Pike Ste D Huber Heights OH 45424-3276 Ph: (937) 795-1101 |
NPI Number | 1053861369 |
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Provider Enumeration Date | 10/11/2016 |
Last Update Date | 05/16/2024 |
Medicare PECOS PAC ID | 5193070779 |
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Medicare Enrollment ID | O20180622000987 |
Identifier | Type | State | Issuer |
---|---|---|---|
1053861369 | NPI | - | NPPES |
2893301 | Medicaid | OH | |
1669694246 | Other | INDIVIDUAL NPI | |
1053861369 | Other | GROUP NPI | |
MA4253051 | Other | LEGACY | |
H598960 | Other | PTAN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 92123 (Ohio) | Primary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Jennifer L Machuca |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1669694246 PECOS PAC ID: 9537224654 Enrollment ID: I20090224000314 |
Community Health Centers Of Greater Dayton Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6255 Chambersburg Rd, Huber Heights, OH 45424 Phone: 937-586-9733 | |
Simply Health For Life, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 6076 Chambersburg Rd, Huber Heights, OH 45424 Phone: 937-623-9883 | |
Striebel Family Practice Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 7391 Brandt Pike, Ste A, Huber Heights, OH 45424 Phone: 937-236-0373 Fax: 937-236-2737 |