Dr Jesse Tellez Hernandez, NP-C is a medicare enrolled "Nurse Practitioner" in Fort Hall, Idaho. His current practice location is
Building 70 Navajo Drive, Fort Hall, Idaho. You can reach out to his office (for appointments etc.) via phone at
(208) 478-3987.
Dr Jesse Tellez Hernandez is licensed to practice in Idaho (license number NP-1663A) 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 1184099558.
Provider's Profile
| Full Name | Dr Jesse Tellez Hernandez |
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| Gender | Male |
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| Speciality | Nurse Practitioner |
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| Location | Building 70 Navajo Drive, Fort Hall, Idaho |
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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: 1184099558
- Provider Enumeration Date: 12/10/2015
- Last Update Date: 03/30/2022
Medicare PECOS Information:
- PECOS PAC ID: 5395080543
- Enrollment ID: I20181217003059
Medical Identifiers
Medical identifiers for Dr Jesse Tellez Hernandez such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1184099558 | NPI | - | NPPES |
| NP-1663A | Other | ID | PROFESSIONAL LICENSE |
| 11948571-4405 | Other | UT | PROFESSIONAL LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | NP-1663A (Idaho) | 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. Dr Jesse Tellez Hernandez allows following entities to bill medicare on his behalf.
| Entity Name | Shoshone Bannock Tribes Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1801949763
PECOS PAC ID: 5496804429
Enrollment ID: O20100330001318 |
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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. Dr Jesse Tellez Hernandez 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 |
|---|
Dr Jesse Tellez Hernandez, NP-C
Po Box 4414,
Pocatello, ID 83205-4414
Ph: (208) 219-9927 | Dr Jesse Tellez Hernandez, NP-C
Building 70 Navajo Drive,
Fort Hall, ID 83203
Ph: (208) 478-3987 |
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