Dr Jared William Boot-haury, PSYD is a medicare enrolled "Psychologist - Clinical" provider in San Francisco, California. His current practice location is
351 King St Unit 122, San Francisco, California. You can reach out to his office (for appointments etc.) via phone at
(734) 604-0920.
Dr Jared William Boot-haury is licensed to practice in California (license number PSY35161) 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 1447809777.
Healthcare Provider's Profile
| Full Name | Dr Jared William Boot-haury |
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| Gender | Male |
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| Speciality | Psychologist - Clinical |
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| Location | 351 King St Unit 122, San Francisco, California |
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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: 1447809777
- Provider Enumeration Date: 09/09/2019
- Last Update Date: 05/04/2025
Medicare PECOS Information:
- PECOS PAC ID: 1456861509
- Enrollment ID: I20250609001891
Medical Identifiers
Medical identifiers for Dr Jared William Boot-haury such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1447809777 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YM0800X | Counselor - Mental Health | 6301018026 (Michigan) | Secondary |
| 103TC0700X | Psychologist - Clinical | 5112-57 (Wisconsin) | Secondary |
| 103TC0700X | Psychologist - Clinical | PSY35161 (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 Jared William Boot-haury allows following entities to bill medicare on his behalf.
| Entity Name | Permanente Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1073606299
PECOS PAC ID: 8921910225
Enrollment ID: O20031104000710 |
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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 Jared William Boot-haury 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 Jared William Boot-haury, PSYD
351 King St Unit 122,
San Francisco, CA 94158-1709
Ph: (734) 604-0920 | Dr Jared William Boot-haury, PSYD
351 King St Unit 122,
San Francisco, CA 94158-1709
Ph: (734) 604-0920 |
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