Jerry Clifton Ivy, PT is a medicare enrolled "Physical Therapist" provider in Joseph, Oregon. He graduated from medical school in 1990 and has 35 years of diverse experience with area of expertise as Physical Therapist In Private Practice. He is a member of the group practice Hana Pono Wellness Center Llc and his current practice location is
4 S Main St Ste B, Joseph, Oregon. You can reach out to his office (for appointments etc.) via phone at
(541) 432-1480.
Jerry Clifton Ivy is licensed to practice in Oregon (license number 2125) 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 1093778680.
Healthcare Provider's Profile
| Full Name | Jerry Clifton Ivy |
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| Gender | Male |
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| Speciality | Physical Therapist In Private Practice |
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| Experience | 35 Years |
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| Location | 4 S Main St Ste B, Joseph, Oregon |
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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:
- Jerry Clifton Ivy graduated from medical school in 1990
NPI Data:
- NPI Number: 1093778680
- Provider Enumeration Date: 04/06/2006
- Last Update Date: 01/16/2020
Medicare PECOS Information:
- PECOS PAC ID: 7810928421
- Enrollment ID: I20241204003894
Medical Identifiers
Medical identifiers for Jerry Clifton Ivy such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1093778680 | NPI | - | NPPES |
| 016852 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 225100000X | Physical Therapist | 2125 (Oregon) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Hana Pono Wellness Center Llc | 2365864337 | 11 |
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. Jerry Clifton Ivy allows following entities to bill medicare on his behalf.
| Provider Name | Hana Pono Wellness Center Llc |
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| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
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| Provider Identifiers | NPI Number: 1225659857
PECOS PAC ID: 2365864337
Enrollment ID: O20200619001356 |
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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. Jerry Clifton Ivy 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 |
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Jerry Clifton Ivy, PT
Po Box 355,
Enterprise, OR 97828-0355
Ph: (541) 426-4870 | Jerry Clifton Ivy, PT
4 S Main St Ste B,
Joseph, OR 97846-8434
Ph: (541) 432-1480 |
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