Dr Jeremy Blank, PSYD is a medicare enrolled "Clinical Neuropsychologist" provider in Temecula, California. He graduated from medical school in 2013 and has 12 years of diverse experience with area of expertise as Clinical Psychologist. His current practice location is
27403 Ynez Rd Ste 205, Temecula, California. You can reach out to his office (for appointments etc.) via phone at
(951) 595-7386.
Dr Jeremy Blank is licensed to practice in California (license number PSY27148) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1215260591.
Healthcare Provider's Profile
Full Name | Dr Jeremy Blank |
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Gender | Male |
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Speciality | Clinical Psychologist |
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Experience | 12 Years |
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Location | 27403 Ynez Rd Ste 205, Temecula, California |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Dr Jeremy Blank graduated from medical school in 2013
NPI Data:
- NPI Number: 1215260591
- Provider Enumeration Date: 09/17/2009
- Last Update Date: 12/16/2023
Medicare PECOS Information:
- PECOS PAC ID: 5294056370
- Enrollment ID: I20150730010948
Medical Identifiers
Medical identifiers for Dr Jeremy Blank such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1215260591 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | PSY27148 (California) | Secondary |
103G00000X | Clinical Neuropsychologist | PSY27148 (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. 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 Jeremy Blank allows following entities to bill medicare on his behalf.
Entity Name | Blank Psychological Services Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1487422747 PECOS PAC ID: 9436501905 Enrollment ID: O20240119002956 |
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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 Jeremy Blank 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 Jeremy Blank, PSYD 27403 Ynez Rd Ste 205, Temecula, CA 92591-4616 Ph: (951) 595-7386 | Dr Jeremy Blank, PSYD 27403 Ynez Rd Ste 205, Temecula, CA 92591-4616 Ph: (951) 595-7386 |
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