Jerrold Paul Elliott Iii, PA-C is a medicare enrolled "Physician Assistant - Medical" in Guerneville, California. He graduated from nursing school in 2008 and has 18 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Providence Medical Foundation and his current practice location is
16319 Third Street, Guerneville, California. You can reach out to his office (for appointments etc.) via phone at
(707) 869-5977.
Jerrold Paul Elliott Iii is licensed to practice in California (license number PA20527) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1982854618.
Provider's Profile
| Full Name | Jerrold Paul Elliott Iii |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 18 Years |
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| Location | 16319 Third Street, Guerneville, California |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Jerrold Paul Elliott Iii graduated from nursing school in 2008
NPI Data:
- NPI Number: 1982854618
- Provider Enumeration Date: 09/30/2008
- Last Update Date: 01/25/2021
Medicare PECOS Information:
- PECOS PAC ID: 9830251263
- Enrollment ID: I20160604000075
Medical Identifiers
Medical identifiers for Jerrold Paul Elliott Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1982854618 | NPI | - | NPPES |
| 1356344758 | Medicaid | CA | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 2666 (Colorado) | Secondary |
| 363AM0700X | Physician Assistant - Medical | PA20527 (California) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Providence Medical Foundation | 8921993205 | 1329 |
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. Jerrold Paul Elliott Iii 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 |
|---|
Jerrold Paul Elliott Iii, PA-C
Po Box 1449,
Guerneville, CA 95446-1449
Ph: (707) 869-5977 | Jerrold Paul Elliott Iii, PA-C
16319 Third Street,
Guerneville, CA 95446
Ph: (707) 869-5977 |
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