Dr Faith Lee-jackson, MD is a medicare enrolled "Family Medicine" physician in San Bernandino, California. She went to University Of California, Irvine, California College Of Medicine and graduated in 1996 and has 28 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Beaver Medical Group Pc and her current practice location is
1700 North Waterman Avenue, San Bernandino, California. You can reach out to her office (for appointments etc.) via phone at
(909) 883-8611.
Dr Faith Lee-jackson is licensed to practice in California (license number A63452) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1699745471.
Physician's Profile
| Full Name | Dr Faith Lee-jackson |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 28 Years |
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| Location | 1700 North Waterman Avenue, San Bernandino, California |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Faith Lee-jackson attended and graduated from University Of California, Irvine, California College Of Medicine in 1996
NPI Data:
- NPI Number: 1699745471
- Provider Enumeration Date: 01/25/2006
- Last Update Date: 09/19/2018
Medicare PECOS Information:
- PECOS PAC ID: 2264505734
- Enrollment ID: I20080716000301
Medical Identifiers
Medical identifiers for Dr Faith Lee-jackson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1699745471 | NPI | - | NPPES |
| OOA634520 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | A63452 (California) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Beaver Medical Group Pc | 0547164295 | 272 |
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 Faith Lee-jackson allows following entities to bill medicare on her behalf.
| Entity Name | Beaver Medical Group Pc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1649503319
PECOS PAC ID: 0547164295
Enrollment ID: O20031124000449 |
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| Entity Name | Healthcare Partners Affiliates Medical Group |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1659312593
PECOS PAC ID: 7315842002
Enrollment ID: O20031204001258 |
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| Entity Name | Redlands Family Practice Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942482021
PECOS PAC ID: 7214249127
Enrollment ID: O20150707001603 |
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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 Faith Lee-jackson 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 Faith Lee-jackson, MD
1700 North Waterman Avenue,
San Bernandino, CA 92404-5105
Ph: (909) 883-8611 | Dr Faith Lee-jackson, MD
1700 North Waterman Avenue,
San Bernandino, CA 92404-5105
Ph: (909) 883-8611 |
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