Blaine S Jensen, PA-C is a medicare enrolled "Physician Assistant" in Superior, Arizona. His current practice location is
1134 W Hwy 60, Superior, Arizona. You can reach out to his office (for appointments etc.) via phone at
(520) 689-2423.
Blaine S Jensen is licensed to practice in Arizona (license number 2322) 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 1023129996.
Provider's Profile
| Full Name | Blaine S Jensen |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 1134 W Hwy 60, Superior, Arizona |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1023129996
- Provider Enumeration Date: 08/31/2006
- Last Update Date: 12/11/2014
Medicare PECOS Information:
- PECOS PAC ID: 4183616584
- Enrollment ID: I20040402000821
Medical Identifiers
Medical identifiers for Blaine S Jensen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1023129996 | NPI | - | NPPES |
| 507147 | Medicaid | AZ | |
| Z69075 | Other | AZ | PTAN |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363A00000X | Physician Assistant | 2322 (Arizona) | Primary |
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. Blaine S Jensen 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 |
Blaine S Jensen, PA-C 1134 W Hwy 60, Superior, AZ 85173-2647 Ph: (520) 689-2423 | Blaine S Jensen, PA-C 1134 W Hwy 60, Superior, AZ 85273-2647 Ph: (520) 689-2423 |
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