Ms Jacqueline Susanna Chan, DO/OSTEOPATH is a medicare enrolled "Family Medicine" physician in Larkspur, California. She went to Ohio University, College Of Osteopathic Medicine and graduated in 1997 and has 27 years of diverse experience with area of expertise as Family Practice. Her current practice location is
1100 Larkspur Landing Circle #255, Larkspur, California. You can reach out to her office (for appointments etc.) via phone at
(415) 945-3213.
Ms Jacqueline Susanna Chan is licensed to practice in California (license number 20A10041) 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 1740267715.
Physician's Profile
| Full Name | Ms Jacqueline Susanna Chan |
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| Gender | Female |
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| Speciality | Family Practice |
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| Experience | 27 Years |
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| Location | 1100 Larkspur Landing Circle #255, Larkspur, 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:
- Ms Jacqueline Susanna Chan attended and graduated from Ohio University, College Of Osteopathic Medicine in 1997
NPI Data:
- NPI Number: 1740267715
- Provider Enumeration Date: 12/29/2005
- Last Update Date: 05/02/2018
Medicare PECOS Information:
- PECOS PAC ID: 4688896756
- Enrollment ID: I20200521002260
Medical Identifiers
Medical identifiers for Ms Jacqueline Susanna Chan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1740267715 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 20A10041 (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. Ms Jacqueline Susanna Chan allows following entities to bill medicare on her behalf.
| Entity Name | Jacqueline S Chan D O A Medical Corporation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1194352930
PECOS PAC ID: 3678994977
Enrollment ID: O20200521002174 |
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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. Ms Jacqueline Susanna Chan 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 |
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Ms Jacqueline Susanna Chan, DO/OSTEOPATH
1100 Larkspur Landing Cir. #255,
Larkspur, CA 94939
Ph: (415) 945-3213 | Ms Jacqueline Susanna Chan, DO/OSTEOPATH
1100 Larkspur Landing Circle #255,
Larkspur, CA 94939
Ph: (415) 945-3213 |
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