Individual ProviderJay Bennett JaffeeAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address12222 Merit Dr Ste 600, Dallas, TX 75251-3294(972) 715-5000(972) 233-1999PECOS EnrollmentThis provider is enrolled in PECOS as JAY JAFFEE.Based on the most recent information from CMS, provider Jay Bennett Jaffee is legally eligible to order and refer claims for DME and PMD services only.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 34 days ago.Profile DetailsProvider ID1114903010Provider TypeIndividualFull NameJaffee, Jay BennettTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date12/22/2005Last Updated6/13/2022Contact InformationPractice LocationPractice Address12222 Merit Dr Ste 600, Dallas, TX 75251-3294Phone(972) 715-5000Fax(972) 715-9976Mailing LocationMailing AddressPO Box 840853, Dallas, TX 75284-0865Phone(972) 233-1999Fax(972) 233-3666Provider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseK0842TexasProvider IdentifiersIDDescriptionIssuerID125082106DescriptionMedicaidIssuerUnlistedTexasID83753KDescriptionOtherIssuerBCBSTexasID8EH335DescriptionOtherIssuerBCBS TXTexasID125082109DescriptionOtherIssuerMEDICAID CSHCNTexas