Dr Jason Jasper Ballew, MD - Medicare Preventive Medicine in Tahlequah, OK

Dr Jason Jasper Ballew, MD is a medicare enrolled "Preventive Medicine - Addiction Medicine" physician in Tahlequah, Oklahoma. His current practice location is 1400 E Downing St, Tahlequah, Oklahoma. You can reach out to his office (for appointments etc.) via phone at (918) 456-0641.

Dr Jason Jasper Ballew is licensed to practice in Oklahoma (license number 25130) 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 1235146036.

Contact Information

Dr Jason Jasper Ballew, MD
1400 E Downing St,
Tahlequah, OK 74464-3324
(918) 456-0641
Not Available



Physician's Profile

Full NameDr Jason Jasper Ballew
GenderMale
SpecialityPreventive Medicine - Addiction Medicine
Location1400 E Downing St, Tahlequah, Oklahoma
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1235146036
  • Provider Enumeration Date: 08/02/2006
  • Last Update Date: 06/23/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 4082614409
  • Enrollment ID: I20070110000016

Medical Identifiers

Medical identifiers for Dr Jason Jasper Ballew such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1235146036NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207P00000XEmergency Medicine 25130 (Oklahoma)Secondary
2083A0300XPreventive Medicine - Addiction Medicine 25130 (Oklahoma)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 Jason Jasper Ballew allows following entities to bill medicare on his behalf.
Entity NameNortheastern Health System
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1457574170
PECOS PAC ID: 1456255025
Enrollment ID: O20031125000250

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Entity NameTahlequah Medical Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1881960771
PECOS PAC ID: 4082861349
Enrollment ID: O20120822000336

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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 Jason Jasper Ballew 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 AddressPractice Location Address
Dr Jason Jasper Ballew, MD
3829 S Madison Ave,
Tulsa, OK 74105-3062

Ph: (918) 316-4330
Dr Jason Jasper Ballew, MD
1400 E Downing St,
Tahlequah, OK 74464-3324

Ph: (918) 456-0641

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Preventive Medicine Doctors in Tahlequah, OK


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