Dr Jesse Sandoval, DO is a medicare enrolled "Phlebology" physician in Soldotna, Alaska. His current practice location is
245 N Binkley St Ste 101, Soldotna, Alaska. You can reach out to his office (for appointments etc.) via phone at
(907) 714-4111.
Dr Jesse Sandoval is licensed to practice in Idaho (license number O124) 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 1972552271.
Physician's Profile
| Full Name | Dr Jesse Sandoval |
|---|
| Gender | Male |
|---|
| Speciality | Phlebology |
|---|
| Location | 245 N Binkley St Ste 101, Soldotna, Alaska |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1972552271
- Provider Enumeration Date: 05/06/2006
- Last Update Date: 12/19/2023
Medicare PECOS Information:
- PECOS PAC ID: 9739168345
- Enrollment ID: I20160407002168
Medical Identifiers
Medical identifiers for Dr Jesse Sandoval such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1972552271 | NPI | - | NPPES |
| S4620 | Other | ID | BLUE CROSS OF IDAHO |
| 200489062 | Other | ID | PRIMARY HEALTH NETWORK |
| 200489062 | Other | ID | TRICARE WEST |
| 0004676625 | Other | ID | AETNA |
| 200489062 | Other | ID | PRINCIPAL LIFE INSURANCE |
| 004314700 | Medicaid | ID | |
| 200489062 | Other | ID | MUTUAL OF OMAHA |
| 200489062 | Other | ID | HCS HEALTH CLAIMS SERVICE |
| 000010145826 | Other | ID | REGENCE BLUE SHEILD |
| 200489062 | Other | ID | UNITED HEALTH CARE |
| 200489062 | Other | ID | CIGNA HEALTH CARE |
| 200489062 | Other | ID | FIRST HEALTH |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 0124 (Idaho) | Secondary |
| 202K00000X | Phlebology | O124 (Idaho) | 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 Jesse Sandoval allows following entities to bill medicare on his behalf.
| Entity Name | Central Peninsula General Hospital Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1528062429
PECOS PAC ID: 4587552575
Enrollment ID: O20040310000598 |
|---|
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 Jesse Sandoval 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 Jesse Sandoval, DO
Po Box 7130,
Boise, ID 83707-1130
Ph: (208) 333-1472 | Dr Jesse Sandoval, DO
245 N Binkley St Ste 101,
Soldotna, AK 99669-7500
Ph: (907) 714-4111 |
Reviews and Comments