Dr Jacob Andrew Sandoval, PHD, LMFT in Boulder, CO - Medicare Marriage & Family Therapist Provider

Dr Jacob Andrew Sandoval, PHD, LMFT is a medicare enrolled "Marriage & Family Therapist" provider in Boulder, Colorado. His current practice location is 1942 Broadway Ste 314c, Boulder, Colorado. You can reach out to his office (for appointments etc.) via phone at (319) 855-7899.

Dr Jacob Andrew Sandoval is licensed to practice in Iowa (license number 100407) 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 1255959391.

Contact Information

	Dr Jacob Andrew Sandoval, PHD, LMFT
	1942 Broadway Ste 314c, Boulder, CO 80302-5233
	(319) 855-7899
	(303) 496-0786

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jacob Andrew Sandoval
Gender	Male
Speciality	Marriage & Family Therapist
Location	1942 Broadway Ste 314c, Boulder, Colorado
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1255959391
Provider Enumeration Date: 07/06/2020
Last Update Date: 10/30/2023

Medicare PECOS Information:

PECOS PAC ID: 2567803638
Enrollment ID: I20240508000214

Medical Identifiers

Medical identifiers for Dr Jacob Andrew Sandoval such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1255959391	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
106H00000X	Marriage & Family Therapist	100407 (Iowa)	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 Jacob Andrew Sandoval allows following entities to bill medicare on his behalf.

Entity Name	Sandoval Therapy And Consulting Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1871273375 PECOS PAC ID: 1658712724 Enrollment ID: O20240508000172

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 Jacob Andrew Sandoval 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
Dr Jacob Andrew Sandoval, PHD, LMFT 6732 W Coal Mine Ave Ste 139, Littleton, CO 80123-4573 Ph: (563) 213-5082	Dr Jacob Andrew Sandoval, PHD, LMFT 1942 Broadway Ste 314c, Boulder, CO 80302-5233 Ph: (319) 855-7899

Reviews and Comments

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Dr Jacob Andrew Sandoval, PHD, LMFT - Medicare Couples Therapy in Boulder, CO