Jaclyn Gamboa, PT in Bend, OR - Medicare Physical Therapist Provider

Jaclyn Gamboa, PT is a medicare enrolled "Physical Therapist - Pediatrics" provider in Bend, Oregon. Her current practice location is 2600 Ne Neff Rd, Bend, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 706-6843.

Jaclyn Gamboa is licensed to practice in Oregon (license number ) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1225649205.

Contact Information

	Jaclyn Gamboa, PT
	2600 Ne Neff Rd, Bend, OR 97701-6337
	(541) 706-6843
	(541) 598-3444

Map and Direction

Healthcare Provider's Profile

Full Name	Jaclyn Gamboa
Gender	Female
Speciality	Physical Therapist - Pediatrics
Location	2600 Ne Neff Rd, Bend, Oregon
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1225649205
Provider Enumeration Date: 08/12/2020
Last Update Date: 02/02/2022

Medicare PECOS Information:

PECOS PAC ID: 7810302338
Enrollment ID: I20210216001009

Medical Identifiers

Medical identifiers for Jaclyn Gamboa such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1225649205	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
2251P0200X	Physical Therapist - Pediatrics	(Oregon)	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. Jaclyn Gamboa allows following entities to bill medicare on her behalf.

Provider Name	St Charles Health System Inc
Provider Type	Part B Supplier - Clinic/group Practice
Provider Identifiers	NPI Number: 1023331303 PECOS PAC ID: 8729111513 Enrollment ID: O20100730000227

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. Jaclyn Gamboa 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
Jaclyn Gamboa, PT 983 Sw 25th Ln, Redmond, OR 97756-1325 Ph: (541) 350-1277	Jaclyn Gamboa, PT 2600 Ne Neff Rd, Bend, OR 97701-6337 Ph: (541) 706-6843

Reviews and Comments

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Craig Andrew Boswell, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 61615 Athletic Club Drive, Bend, OR 97702 Phone: 541-382-7890 Fax: 541-382-7498
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Jaclyn Gamboa, PT - Medicare Physical Therapist in Bend, OR