Roosevelt Dean Jr, DO is a medicare enrolled "Family Medicine" physician in King George, Virginia. His current practice location is
11131 Journal Parkway, King George, Virginia. You can reach out to his office (for appointments etc.) via phone at
(540) 625-2527.
Roosevelt Dean Jr is licensed to practice in Virginia (license number 0102202137) 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 1245486802.
Physician's Profile
| Full Name | Roosevelt Dean Jr |
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| Gender | Male |
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| Speciality | Family Medicine |
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| Location | 11131 Journal Parkway, King George, Virginia |
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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: 1245486802
- Provider Enumeration Date: 08/14/2008
- Last Update Date: 03/06/2015
Medicare PECOS Information:
- PECOS PAC ID: 5799832804
- Enrollment ID: I20160921000039
Medical Identifiers
Medical identifiers for Roosevelt Dean Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1245486802 | NPI | - | NPPES |
| 1245486802 | Medicaid | VA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 0102202137 (Virginia) | 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. Roosevelt Dean Jr allows following entities to bill medicare on his behalf.
| Entity Name | Privia Medical Group Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013042480
PECOS PAC ID: 4385682061
Enrollment ID: O20050422000298 |
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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. Roosevelt Dean Jr 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 |
|---|
Roosevelt Dean Jr, DO
11131 Journal Parkway,
King George, VA 22485
Ph: (540) 625-2527 | Roosevelt Dean Jr, DO
11131 Journal Parkway,
King George, VA 22485
Ph: (540) 625-2527 |
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