Dr Wanda Jimenez, MDMPH is a medicare enrolled "Preventive Medicine - Public Health & General Preventive Medicine" physician in Centralia, Washington. Her current practice location is
1707 Cooks Hill Rd, Centralia, Washington. You can reach out to her office (for appointments etc.) via phone at
(360) 736-1961.
Dr Wanda Jimenez is licensed to practice in New York (license number 175463) 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 1306867700.
Physician's Profile
| Full Name | Dr Wanda Jimenez |
|---|
| Gender | Female |
|---|
| Speciality | Preventive Medicine - Public Health & General Preventive Medicine |
|---|
| Location | 1707 Cooks Hill Rd, Centralia, Washington |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1306867700
- Provider Enumeration Date: 07/21/2006
- Last Update Date: 07/19/2010
Medicare PECOS Information:
- PECOS PAC ID: 2466419270
- Enrollment ID: I20080930000259
Medical Identifiers
Medical identifiers for Dr Wanda Jimenez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1306867700 | NPI | - | NPPES |
| 0239255 | Other | WA | LABOR & INDUSTRIES |
| 8118JI | Other | | REGENCE |
| 8530024 | Medicaid | WA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 2083P0901X | Preventive Medicine - Public Health & General Preventive Medicine | 175463 (New York) | Primary |
| 207Q00000X | Family Medicine | MD00048802 (Washington) | Secondary |
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 Wanda Jimenez allows following entities to bill medicare on her behalf.
| Entity Name | Rejuventa Medical Corp |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1013550987
PECOS PAC ID: 6305270844
Enrollment ID: O20191216003122 |
|---|
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 Wanda Jimenez 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 Wanda Jimenez, MDMPH
1707 Cooks Hill Rd,
Centralia, WA 98531-9071
Ph: (360) 736-1965 | Dr Wanda Jimenez, MDMPH
1707 Cooks Hill Rd,
Centralia, WA 98531-9071
Ph: (360) 736-1961 |
Reviews and Comments