Jericho De Mata, DO in Upper Marlboro, MD

Jericho De Mata, DO is a medicare enrolled "Family Medicine" physician in Upper Marlboro, Maryland. His current practice location is 1221 Mercantile Ln, Upper Marlboro, Maryland. You can reach out to his office (for appointments etc.) via phone at (301) 618-5500.

Jericho De Mata is licensed to practice in Maryland (license number H83783) 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 1275950396.

Contact Information

	Jericho De Mata, DO
	1221 Mercantile Ln, Upper Marlboro, MD 20774-5374
	(301) 618-5500
	Not Available

Map and Direction

Physician's Profile

Full Name	Jericho De Mata
Gender	Male
Speciality	Family Medicine
Location	1221 Mercantile Ln, Upper Marlboro, Maryland
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1275950396
Provider Enumeration Date: 03/26/2014
Last Update Date: 06/20/2021

Medicare PECOS Information:

PECOS PAC ID: 3971879958
Enrollment ID: I20171018002053

Medical Identifiers

Medical identifiers for Jericho De Mata such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275950396	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	MD045539 (District Of Columbia)	Secondary
207Q00000X	Family Medicine	0102205000 (Virginia)	Secondary
207Q00000X	Family Medicine	H83783 (Maryland)	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. Jericho De Mata allows following entities to bill medicare on his behalf.

Entity Name	Kaiser Foundation Health Plan Of The Mid Atlantic States, Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1952461816 PECOS PAC ID: 3779495858 Enrollment ID: O20040105000308

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. Jericho De Mata 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
Jericho De Mata, DO 2101 E Jefferson St Ste 6w, Rockville, MD 20852-4908 Ph: (301) 816-5853	Jericho De Mata, DO 1221 Mercantile Ln, Upper Marlboro, MD 20774-5374 Ph: (301) 618-5500

Reviews and Comments

Family Medicine Doctors in Upper Marlboro, MD

Dr. Madeline Nicole Bota Brown, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 9109 Garden Knoll Ln, Upper Marlboro, MD 20772 Phone: 484-350-8082
Dr. Olufemi Ebunolu Balogun, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1221 Mercantile Ln, Upper Marlboro, MD 20774 Phone: 301-618-5500
Chika Anyanwu, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 9440 Marlboro Pike, Suite 200, Upper Marlboro, MD 20772 Phone: 240-525-6530
David Auh, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1221 Mercantile Ln, Upper Marlboro, MD 20774 Phone: 301-618-5500
Alyssa Mckenna, DO Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1221 Mercantile Lane, Upper Marlboro, MD 20774 Phone: 301-386-6600 Fax: 724-770-7947
Dr. John Herman Wills, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 14310 Old Marlboro Pike, Upper Marlboro, MD 20772 Phone: 301-627-1448 Fax: 301-627-5010

Jericho De Mata, DO - Medicare Family Medicine in Upper Marlboro, MD