Dr Jennifer Anne Theoharis, MD is a medicare enrolled "Radiology - Diagnostic Radiology" physician in Boerne, Texas. Her current practice location is
9002 Highlands Cv, Boerne, Texas. You can reach out to her office (for appointments etc.) via phone at
(952) 595-1100.
Dr Jennifer Anne Theoharis is licensed to practice in Texas (license number M0943) 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 1659356913.
Physician's Profile
| Full Name | Dr Jennifer Anne Theoharis |
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| Gender | Female |
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| Speciality | Radiology - Diagnostic Radiology |
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| Location | 9002 Highlands Cv, Boerne, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1659356913
- Provider Enumeration Date: 12/09/2005
- Last Update Date: 08/16/2013
Medicare PECOS Information:
- PECOS PAC ID: 1456380922
- Enrollment ID: I20130416000639
Medical Identifiers
Medical identifiers for Dr Jennifer Anne Theoharis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1659356913 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 2085R0202X | Radiology - Diagnostic Radiology | A85035 (California) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 045784 (Connecticut) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | M0943 (Texas) | 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 Jennifer Anne Theoharis allows following entities to bill medicare on her behalf.
| Entity Name | South Texas Radiology Group Pa |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1851368039 PECOS PAC ID: 2567365083 Enrollment ID: O20040130000694 |
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| Entity Name | South Texas Radiology Imaging Centers |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1396718334 PECOS PAC ID: 0547153512 Enrollment ID: O20040204000215 |
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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 Jennifer Anne Theoharis 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 Jennifer Anne Theoharis, MD 11995 Singletree Ln, Suite 500, Eden Prairie, MN 55344-5347 Ph: (952) 595-1301 | Dr Jennifer Anne Theoharis, MD 9002 Highlands Cv, Boerne, TX 78006-4843 Ph: (952) 595-1100 |
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