Dr Jacqueline Maria Fennerty, DPM is a medicare enrolled "Podiatrist" provider in Springfield, Oregon. She went to California School Of Podiatric Medicine and graduated in 1996 and has 29 years of diverse experience with area of expertise as Podiatry. She is a member of the group practice G Street Integrated Health and her current practice location is
1435 G St, Springfield, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 735-9420.
Dr Jacqueline Maria Fennerty is licensed to practice in Oregon (license number DP00292) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1992871495.
Healthcare Provider's Profile
| Full Name | Dr Jacqueline Maria Fennerty |
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| Gender | Female |
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| Speciality | Podiatry |
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| Experience | 29 Years |
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| Location | 1435 G St, Springfield, Oregon |
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| Accepts Medicare Assignments | Yes. She 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:
- Dr Jacqueline Maria Fennerty attended and graduated from California School Of Podiatric Medicine in 1996
NPI Data:
- NPI Number: 1992871495
- Provider Enumeration Date: 11/27/2006
- Last Update Date: 01/14/2025
Medicare PECOS Information:
- PECOS PAC ID: 1254435076
- Enrollment ID: I20070403000383
Medical Identifiers
Medical identifiers for Dr Jacqueline Maria Fennerty such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1992871495 | NPI | - | NPPES |
| 150584 | Medicaid | OR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 213E00000X | Podiatrist | DP00292 (Oregon) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| G Street Integrated Health | 6800126145 | 17 |
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 Jacqueline Maria Fennerty allows following entities to bill medicare on her behalf.
| Provider Name | G Street Integrated Health |
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| Provider Type | Part B Supplier - Clinic/group Practice |
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| Provider Identifiers | NPI Number: 1730734161
PECOS PAC ID: 6800126145
Enrollment ID: O20190930000321 |
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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 Jacqueline Maria Fennerty 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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Dr Jacqueline Maria Fennerty, DPM
25121 Tripp Rd,
Elmira, OR 97437-9612
Ph: (415) 219-3875 | Dr Jacqueline Maria Fennerty, DPM
1435 G St,
Springfield, OR 97477-4113
Ph: (541) 735-9420 |
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