Jill Efta Breitbach, PSY D is a medicare enrolled "Psychologist - Clinical" provider in Coeur D'alene, Idaho. Her current practice location is
296 W. Sunset Ave, Ste 15, Coeur D'alene, Idaho. You can reach out to her office (for appointments etc.) via phone at
(208) 666-0357.
Jill Efta Breitbach is licensed to practice in Alabama (license number 1287) 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 1487626529.
Healthcare Provider's Profile
| Full Name | Jill Efta Breitbach |
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| Gender | Female |
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| Speciality | Psychologist - Clinical |
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| Location | 296 W. Sunset Ave, Coeur D'alene, 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: 1487626529
- Provider Enumeration Date: 02/03/2006
- Last Update Date: 08/07/2023
Medicare PECOS Information:
- PECOS PAC ID: 6002288396
- Enrollment ID: I20230215000641
Medical Identifiers
Medical identifiers for Jill Efta Breitbach such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1487626529 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 103TC0700X | Psychologist - Clinical | 1287 (Alabama) | 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. Jill Efta Breitbach allows following entities to bill medicare on her behalf.
| Entity Name | The Gordian Mind |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1356054423
PECOS PAC ID: 5193197481
Enrollment ID: O20230215000493 |
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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. Jill Efta Breitbach 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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Jill Efta Breitbach, PSY D
296 W. Sunset Ave, Ste 15,
Coeur D'alene, ID 83815-8366
Ph: (208) 666-0357 | Jill Efta Breitbach, PSY D
296 W. Sunset Ave, Ste 15,
Coeur D'alene, ID 83815-8366
Ph: (208) 666-0357 |
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