Jim D Blunk, DO is a medicare enrolled "Family Medicine" physician in Caldwell, Kansas. His current practice location is
415 S Osage St, Caldwell, Kansas. You can reach out to his office (for appointments etc.) via phone at
(620) 845-2516.
Jim D Blunk is licensed to practice in Kansas (license number 05-19457) 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 1962402537.
Physician's Profile
| Full Name | Jim D Blunk |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 415 S Osage St, Caldwell, Kansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1962402537
- Provider Enumeration Date: 07/26/2005
- Last Update Date: 02/08/2018
Medicare PECOS Information:
- PECOS PAC ID: 1153387220
- Enrollment ID: I20050506000441
Medical Identifiers
Medical identifiers for Jim D Blunk such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1962402537 | NPI | - | NPPES |
| 100229560B | Medicaid | KS | |
| 100193490B | Medicaid | OK | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | 2082 (Oklahoma) | Secondary |
| 207Q00000X | Family Medicine | 05-19457 (Kansas) | 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. Jim D Blunk allows following entities to bill medicare on his behalf.
| Entity Name | Integris Bass Baptist Health Center |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1942201397
PECOS PAC ID: 0345151981
Enrollment ID: O20050419000843 |
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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. Jim D Blunk 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 |
|---|
Jim D Blunk, DO
5300 N Independence Ave, 280,
Oklahoma City, OK 73112-5556
Ph: (620) 845-2516 | Jim D Blunk, DO
415 S Osage St,
Caldwell, KS 67022-1650
Ph: (620) 845-2516 |
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