Dr Jacob Daniel Carlisle, DDS in Benton Harbor, MI

Dr Jacob Daniel Carlisle, DDS is a medicare enrolled "Dentist" provider in Benton Harbor, Michigan. His current practice location is 800 M 139, Benton Harbor, Michigan. You can reach out to his office (for appointments etc.) via phone at (855) 869-6900.

Dr Jacob Daniel Carlisle is licensed to practice in Michigan (license number 2901600138) 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 1437718301.

Contact Information

	Dr Jacob Daniel Carlisle, DDS
	800 M 139, Benton Harbor, MI 49022-3881
	(855) 869-6900
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Jacob Daniel Carlisle
Gender	Male
Speciality	Dentist
Location	800 M 139, Benton Harbor, Michigan
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1437718301
Provider Enumeration Date: 06/13/2019
Last Update Date: 06/13/2019

Medicare PECOS Information:

PECOS PAC ID: 6406183896
Enrollment ID: I20190807003509

Medical Identifiers

Medical identifiers for Dr Jacob Daniel Carlisle such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1437718301	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	2901600138 (Michigan)	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 Daniel Carlisle allows following entities to bill medicare on his behalf.

Entity Name	Intercare Community Health Network
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1326058512 PECOS PAC ID: 9537061254 Enrollment ID: O20040223000150

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 Daniel Carlisle 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 Daniel Carlisle, DDS 822 Ship St Apt 5, Saint Joseph, MI 49085-1138 Ph: () -	Dr Jacob Daniel Carlisle, DDS 800 M 139, Benton Harbor, MI 49022-3881 Ph: (855) 869-6900

Reviews and Comments

Dentist in Benton Harbor, MI

Dr. Daniel Rupert Mcginn, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 800 M 139, Benton Harbor, MI 49022 Phone: 269-927-5400 Fax: 269-927-1956
Kayla Tillman Marshall, Dentist Medicare: Medicare Enrolled Practice Location: 800 M-139, Benton Harbor, MI 49022 Phone: 800-869-6900 Fax: 269-427-5180
Dr. Leo S Saucer, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 870 Union St, Benton Harbor, MI 49022 Phone: 269-925-8691
Eunkyoung Diane E Lee, D.D.S Dentist Medicare: Not Enrolled in Medicare Practice Location: 143 E Main St, Benton Harbor, MI 49022 Phone: 269-927-1313 Fax: 269-934-9447
Pamela L Pappas, DDS Dentist Medicare: Medicare Enrolled Practice Location: 800 M-139, Benton Harbor, MI 49022 Phone: 269-927-5300 Fax: 269-927-1956
Dr. Matthew Veenstra, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 800 M 139, Benton Harbor, MI 49022 Phone: 269-849-8251

Dr Jacob Daniel Carlisle, DDS - Medicare Dentist in Benton Harbor, MI