Dr Kristin Keli Jacobson Pura, PSYD, ABPP - Medicare in Tracy, CA

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Dr Kristin Keli Jacobson Pura, PSYD, ABPP is a medicare enrolled "Clinical Neuropsychologist" provider in Tracy, California. Her current practice location is 2185 W Grant Line Rd, Tracy, California. You can reach out to her office (for appointments etc.) via phone at (209) 839-6282.

Dr Kristin Keli Jacobson Pura is licensed to practice in California (license number PSY26477) 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 1548493760.

Contact Information

Dr Kristin Keli Jacobson Pura, PSYD, ABPP
2185 W Grant Line Rd,
Tracy, CA 95377-7309
(209) 839-6282
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameDr Kristin Keli Jacobson Pura
GenderFemale
SpecialityClinical Neuropsychologist
Location2185 W Grant Line Rd, Tracy, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1548493760
  • Provider Enumeration Date: 09/03/2009
  • Last Update Date: 10/21/2022
  Medicare PECOS Information:
  • PECOS PAC ID: 0840410742
  • Enrollment ID: I20140926001886

Medical Identifiers

Medical identifiers for Dr Kristin Keli Jacobson Pura such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1548493760NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
103T00000XPsychologist PSY26477 (California)Secondary
103G00000XClinical Neuropsychologist PSY26477 (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 Kristin Keli Jacobson Pura allows following entities to bill medicare on her behalf.
Entity NamePermanente Medical Group Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710

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 Kristin Keli Jacobson Pura 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 AddressPractice Location Address
Dr Kristin Keli Jacobson Pura, PSYD, ABPP
2185 W Grant Line Rd,
Tracy, CA 95377-7309

Ph: (209) 839-6282		Dr Kristin Keli Jacobson Pura, PSYD, ABPP
2185 W Grant Line Rd,
Tracy, CA 95377-7309

Ph: (209) 839-6282

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.