Jade Dardine, MD is a medicare enrolled "Family Medicine" physician in Ponderay, Idaho. Her current practice location is
30410 Highway 200, Ponderay, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 263-7101.
Jade Dardine is licensed to practice in Idaho (license number M-13138) 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 1720493638.
Physician's Profile
| Full Name | Jade Dardine |
|---|
| Gender | Female |
|---|
| Speciality | Family Medicine |
|---|
| Location | 30410 Highway 200, Ponderay, Idaho |
|---|
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1720493638
- Provider Enumeration Date: 06/30/2014
- Last Update Date: 12/27/2017
Medicare PECOS Information:
- PECOS PAC ID: 1759687247
- Enrollment ID: I20160309001421
Medical Identifiers
Medical identifiers for Jade Dardine such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1720493638 | NPI | - | NPPES |
| M-13138 | Other | ID | STATE MEDICAL LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | M-13138 (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. Jade Dardine allows following entities to bill medicare on her behalf.
| Entity Name | Internal Medicine Associates, P.a. |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1154361988
PECOS PAC ID: 1759366818
Enrollment ID: O20040622001333 |
|---|
| Entity Name | Bonner General Hospital Inc |
|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
|---|
| Entity Identifiers | NPI Number: 1154563963
PECOS PAC ID: 4082690466
Enrollment ID: O20040626000014 |
|---|
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. Jade Dardine 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 |
|---|
Jade Dardine, MD
30410 Highway 200,
Ponderay, ID 83852-9601
Ph: (208) 263-7101 | Jade Dardine, MD
30410 Highway 200,
Ponderay, ID 83852-9601
Ph: (208) 263-7101 |
Reviews and Comments