Dr Jacqueline Marie Johnson, DO - Medicare Family Practice in Myrtle Creek, OR

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Dr Jacqueline Marie Johnson, DO is a medicare enrolled "Family Medicine" physician in Myrtle Creek, Oregon. She went to At Still University Of Health Sciences, College Of Osteo Med, Kirksville and graduated in 2006 and has 18 years of diverse experience with area of expertise as Family Practice. She is a member of the group practice Centennial Medical Group East Llc and her current practice location is 145 Ne Broadway St, Myrtle Creek, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 677-7200.

Dr Jacqueline Marie Johnson is licensed to practice in Oregon (license number DO161555) 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 1083814099.

Contact Information

Dr Jacqueline Marie Johnson, DO
145 Ne Broadway St,
Myrtle Creek, OR 97457-9039
(541) 677-7200
(541) 229-3309

Map and Direction




Physician's Profile

Full NameDr Jacqueline Marie Johnson
GenderFemale
SpecialityFamily Practice
Experience18 Years
Location145 Ne Broadway St, Myrtle Creek, Oregon
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Jacqueline Marie Johnson attended and graduated from At Still University Of Health Sciences, College Of Osteo Med, Kirksville in 2006
  NPI Data:
  • NPI Number: 1083814099
  • Provider Enumeration Date: 07/19/2007
  • Last Update Date: 08/09/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 0244470805
  • Enrollment ID: I20130703000184

Medical Identifiers

Medical identifiers for Dr Jacqueline Marie Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1083814099NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine O-0482 (Idaho)Secondary
207Q00000XFamily Medicine DO161555 (Oregon)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Amedisys Hospice CareRoseburg, ORHospice
Mercy Medical CenterRoseburg, ORHospital
Adventist Health PortlandPortland, ORHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Centennial Medical Group East Llc923439787853

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 Jacqueline Marie Johnson allows following entities to bill medicare on her behalf.
Entity NamePortland Adventist Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1215910302
PECOS PAC ID: 7012827876
Enrollment ID: O20040226000131
Entity NameCentennial Medical Group East Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1134436637
PECOS PAC ID: 9234397878
Enrollment ID: O20120228000510
Entity NamePortland Adventist Medical Center
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1750091021
PECOS PAC ID: 3274908819
Enrollment ID: O20230412001327

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 Jacqueline Marie Johnson 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 Jacqueline Marie Johnson, DO
2570 Nw Edenbower Blvd Ste 100,
Roseburg, OR 97471-6214

Ph: (541) 677-7200		Dr Jacqueline Marie Johnson, DO
145 Ne Broadway St,
Myrtle Creek, OR 97457-9039

Ph: (541) 677-7200

Reviews and Comments


Family Medicine Doctors in Myrtle Creek, OR

Mark Michael Herscher, D.O.
Family Medicine
Medicare: Medicare Enrolled
Practice Location: 145 Ne Broadway, Myrtle Creek, OR 97457
Phone: 541-863-3146    Fax: 541-863-3226
Tom Lin, MD
Family Medicine
Medicare: Accepting Medicare Assignments
Practice Location: 145 Ne Broadway St, Myrtle Creek, OR 97457
Phone: 541-677-7200    Fax: 541-229-3309

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.