Mr Steven M Jack, LCSW is a medicare enrolled "Social Worker - Clinical" provider in Killingworth, Connecticut. He graduated from healthcare school in 1997 and has 27 years of diverse experience with area of expertise as Clinical Social Worker. He is a member of the group practice Northeast Medical Group Inc and his current practice location is
166 Route 81, Killingworth, Connecticut. You can reach out to his office (for appointments etc.) via phone at
(860) 975-8410.
Mr Steven M Jack is licensed to practice in Connecticut (license number 009168) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1760621577.
Healthcare Provider's Profile
Full Name | Mr Steven M Jack |
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Gender | Male |
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Speciality | Clinical Social Worker |
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Experience | 27 Years |
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Location | 166 Route 81, Killingworth, Connecticut |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Mr Steven M Jack graduated from medical school in 1997
NPI Data:
- NPI Number: 1760621577
- Provider Enumeration Date: 02/18/2009
- Last Update Date: 03/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 9537325212
- Enrollment ID: I20151218000941
Medical Identifiers
Medical identifiers for Mr Steven M Jack such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760621577 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
101YM0800X | Counselor - Mental Health | C004015 (North Carolina) | Secondary |
1041C0700X | Social Worker - Clinical | 009168 (Connecticut) | Primary |
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Northeast Medical Group Inc | 1254233836 | 1244 |
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. Mr Steven M Jack allows following entities to bill medicare on his behalf.
Entity Name | Northeast Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1043278351 PECOS PAC ID: 1254233836 Enrollment ID: O20040123000522 |
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Entity Name | Cynthia L Sarris Pa Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1639505043 PECOS PAC ID: 9032015243 Enrollment ID: O20140227001066 |
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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. Mr Steven M Jack 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 |
Mr Steven M Jack, LCSW 32 Parker Hill Rd, Killingworth, CT 06419-2306 Ph: (860) 975-8410 | Mr Steven M Jack, LCSW 166 Route 81, Killingworth, CT 06419-1481 Ph: (860) 975-8410 |
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