Jacob Goldstein, is a medicare enrolled "Social Worker - Clinical" provider in Indianapolis, Indiana. His current practice location is
2506 Willowbrook Pkwy, Indianapolis, Indiana. You can reach out to his office (for appointments etc.) via phone at
(765) 288-1928.
Jacob Goldstein is licensed to practice in Indiana (license number 34006843A) 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 1902212582.
Healthcare Provider's Profile
Full Name | Jacob Goldstein |
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Gender | Male |
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Speciality | Social Worker - Clinical |
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Location | 2506 Willowbrook Pkwy, Indianapolis, Indiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1902212582
- Provider Enumeration Date: 07/03/2014
- Last Update Date: 06/08/2015
Medicare PECOS Information:
- PECOS PAC ID: 7012134695
- Enrollment ID: I20140805001145
Medical Identifiers
Medical identifiers for Jacob Goldstein such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1902212582 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 87000403A (Indiana) | Secondary |
1041C0700X | Social Worker - Clinical | 34006843A (Indiana) | 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. Jacob Goldstein allows following entities to bill medicare on his behalf.
Entity Name | Meridian Health Services Corp |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1992755490 PECOS PAC ID: 5597679845 Enrollment ID: O20031119000531 |
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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. Jacob Goldstein 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 |
Jacob Goldstein, 240 N Tillotson Ave, Muncie, IN 47304-3988 Ph: (765) 288-1928 | Jacob Goldstein, 2506 Willowbrook Pkwy, Indianapolis, IN 46205-1564 Ph: (765) 288-1928 |
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