Dr Jacqueline Maria Fennerty, DPM - Medicare Podiatrist in Elmira, OR

Dr Jacqueline Maria Fennerty, DPM is a medicare enrolled "Podiatrist" provider in Elmira, Oregon. Her current practice location is 25121 Tripp Rd, Elmira, Oregon. You can reach out to her office (for appointments etc.) via phone at (541) 521-9387.

Dr Jacqueline Maria Fennerty is licensed to practice in Oregon (license number DP00292) 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 1992871495.

Contact Information

Dr Jacqueline Maria Fennerty, DPM
25121 Tripp Rd,
Elmira, OR 97437-9612
(541) 521-9387
(541) 302-9481



Healthcare Provider's Profile

Full NameDr Jacqueline Maria Fennerty
GenderFemale
SpecialityPodiatrist
Location25121 Tripp Rd, Elmira, Oregon
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1992871495
  • Provider Enumeration Date: 11/27/2006
  • Last Update Date: 01/12/2023
  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.
IdentifierTypeStateIssuer
1992871495NPI-NPPES
150584MedicaidOR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
213E00000XPodiatrist DP00292 (Oregon)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 Jacqueline Maria Fennerty allows following entities to bill medicare on her behalf.
Provider NamePpc Group Llc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1508190661
PECOS PAC ID: 4789723115
Enrollment ID: O20091125000080

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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 AddressPractice Location Address
Dr Jacqueline Maria Fennerty, DPM
25121 Tripp Rd,
Elmira, OR 97437-9612

Ph: (415) 219-3875
Dr Jacqueline Maria Fennerty, DPM
25121 Tripp Rd,
Elmira, OR 97437-9612

Ph: (541) 521-9387

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Podiatrist in Elmira, OR


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