Vicki Jetter, MD - Medicare Pediatrics in Baldwin Harbour, NY

Vicki Jetter, MD is a medicare enrolled "Pediatrics" physician in Baldwin Harbour, New York. Her current practice location is 860 Atlantic Ave, Baldwin Harbour, New York. You can reach out to her office (for appointments etc.) via phone at (516) 868-6100.

Vicki Jetter is licensed to practice in New York (license number 168846) 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 1639198633.

Contact Information

Vicki Jetter, MD
860 Atlantic Ave,
Baldwin Harbour, NY 11510
(516) 868-6100
(516) 546-8621



Physician's Profile

Full NameVicki Jetter
GenderFemale
SpecialityPediatrics
Location860 Atlantic Ave, Baldwin Harbour, New York
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1639198633
  • Provider Enumeration Date: 07/19/2006
  • Last Update Date: 09/05/2012
  Medicare PECOS Information:
  • PECOS PAC ID: 9133381973
  • Enrollment ID: I20120424000514

Medical Identifiers

Medical identifiers for Vicki Jetter such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1639198633NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
208000000XPediatrics 168846 (New York)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. Vicki Jetter allows following entities to bill medicare on her behalf.
Entity NameOptum Medical Care Pc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1982643003
PECOS PAC ID: 9931013240
Enrollment ID: O20031119000321

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Entity NameProhealth Care Associates Llp
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1275596280
PECOS PAC ID: 4486544186
Enrollment ID: O20040317000468

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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. Vicki Jetter 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
Vicki Jetter, MD
990 Stewart Ave, Suite 400,
Garden City, NY 11530-4822

Ph: (516) 222-2022
Vicki Jetter, MD
860 Atlantic Ave,
Baldwin Harbour, NY 11510

Ph: (516) 868-6100

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› Verified 2 days ago


Pediatrics Doctors in Baldwin Harbour, NY


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